Published: 15 October 2018

Integrated interventions to reduce pressure on acute hospitals. An evidence review

This HRB evidence review identifies 13 integrated interventions between the hospital and the community  that were tested to see if they reduce pressure on acute hospitals among adults. In this review, a reduction in pressure on acute hospitals was measured by a reduction in adult: admissions to hospital; readmissions for the same condition; length of stay in hospital; emergency department use, and cost. The 13 interventions are discharge management; discharge management using a quality improvement approach; chronic care model; chronic disease management; complex interventions; multidisciplinary teams; self-management; case management; pharmacist-led medication management; hospital at home; non-traditional emergency department interventions; specialised multidisciplinary rehabilitation for hip fracture, and interactive telemedicine.

The review included 36 published  systematic reviews and 1 umbrella review. The HRB review examined seven complex integrated interventions targeted at people with chronic disease, eight interventions to deal with medical and surgical conditions, and three interventions for older people. The findings indicate that there are a number of promising interventions that reduce pressure on acute hospitals for people with chronic diseases. There are a few promising interventions that reduce pressure on acute hospitals for people with medical and surgical conditions. There are no promising interventions that reduce pressure on acute hospitals for older people, but there is some research in progress.


  • Martin Keane
  • Camille Coyle
  • Louise Farragher
  • Gerald O'Nolan
  • Aoife Cannon
  • Jean Long

Publication (PDF, 2 MB)

Publication (PDF, 2 MB)

Health Research Board
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