Abstract
SummaryQuestionDoes comprehensive discharge planning and post-discharge support reduce readmission rates for older people with congestive heart failure?Study DesignSystematic review with meta-analysis.Main results18 RCTs (N=3304) met inclusion criteria. Comprehensive discharge planning and post-discharge support significantly reduced re-admission rates compared with usual care (35% vs. 43%; p<0.001: see Results table). There were no significant differences in mortality or length of hospital stay between groups (intervention vs. usual care—mortality 14% vs. 17%, p=0.06; length of hospital stay 8.4 days vs. 8.5 days, p=0.60). The intervention increased quality of life scores significantly more from baseline compared with usual care (25.7%; 95%CI 11.0 to 40.4% vs. 13.5%, 95%CI 5.1% to 22.0%). There was no significant increase in monthly medical costs per patient between groups (-$536, 95%CI $956 to -$115, for US trials).Authors’ conclusionsIn elderly people with congestive heart failure, comprehensive discharge planning with post-discharge support significantly reduced readmission rates. Routine application of such an intervention should be considered.
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