Previous reviews by Parkes and Shepperd41
and Parker et al,42 which summarized
the experience of a heterogeneous
patient population assigned to discharge
planning or usual care, reported
mixed results. The first study reported
lower 1-month readmission rate for
medical patients; however, equivocal results
were found for combined medical
and surgical patients in the second study.
In our review, we selected a clearly defined
group of hospitalized patients with
CHF, mean age 55 years or older, with
moderate to severe heart failure symptoms
and moderate to severe LV systolic
dysfunction, clinical characteristics
that are typical of most patients with
heart failure nationwide. Our findings
confirm the efficacy of comprehensive
discharge planning plus postdischarge