Aim: to provide an evidence base for strategies, and effectiveness of the transfer of patient information between hospital and community for older people with physical illness.
Design: a systematic review of qualitative and quantitative literature.
Search strategy: literature from medical, health-related and social science databases as well as work in progress from national databases, the Internet, British PhD theses and other grey literature and policy documents.
Selection criteria: literature relating to similar healthcare systems published between January 1994 and June 2000 on hospital discharge planning. Empirical studies from peer reviewed sources; theoretical papers from non-peer reviewed sources; research papers from non-peer reviewed sources and professional documents.
Data collection and analysis: extracted data from empirical studies under the headings of location, sector, research questions and study design and duration. We made structured summaries of all other data sources and used them to supply context and background. We categorized literature and analysed it in terms of method and analysis, quality and strength of evidence and its relevance to the research questions. We synthesized the results and presented them in terms of answers to our research questions.
Results: a database of 373 potentially relevant studies and of these, 53 were accepted for further analysis. Thirty-one were empirical studies, most of which were qualitative or a combination of qualitative and quantitative in design. The most effective strategy for transferring information is the appointment of a 'key worker', who can provide a point of contact for workers from hospital and community. Nevertheless, problems have arisen because both settings are under pressure and pursuing different goals. Neither setting is fully aware of the needs, limitations and pressures of the other.
Conclusion: raised awareness and the establishment of common goals are the first steps needed to bridge the divide between health and social care staff in hospital and the community.