A total of 25 studies were included in the review (number of patients not reported): 21 RCTs; two concurrent cohort studies; one matched-pair design; and one quasi-experimental design. Duration of follow-up ranged from seven days to 24 months. Mean study quality was 3.1 (range 2 to 5).
Hospital outcomes:
Length of stay was significantly shortened in intervention groups (eight studies), although it also increased (two studies) or did not significantly differ (nine studies). For most studies no significant differences in readmission rates were observed; some studies reported significant effects on readmission (four studies)
Patient outcomes:
Two studies reported a significant reduction in mortality rates. Six studies reported significant differences for quality of life measures at periods between two weeks and three months post-enrolment. Five studies did not find differences for quality of life measures between three to six months post enrolment. Significant functional improvements were also noted (four trials) as well as increased satisfaction with care received (three studies).
An overall effect size was computed for statistically significant results, where data were provided (effect size 0.51, standard deviation 0.35). Large effects were noted for patient satisfaction and moderate effects were evident for patients' quality of life and readmission rates.