***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: CONTEXT Comprehensive discharge planning by advanced practice nurses has demonstrated short-term reductions in readmissions of elderly patients , but the benefits of more intensive follow-up of hospitalized elders at risk for poor outcomes after discharge has not been studied . OBJECTIVE To examine the effectiveness of an advanced practice nurse-centered discharge planning and home follow-up intervention for elders at risk for hospital readmissions .  DESIGN R and omized clinical trial with follow-up at 2 , 6 , 12 , and 24 weeks after index hospital discharge . SETTING Two urban , academically affiliated hospitals in Philadelphia , Pa. PARTICIPANTS Eligible patients were 65 years or older , hospitalized between August 1992 and March 1996 , and had 1 of several medical and surgical reasons for admission . INTERVENTION Intervention group patients received a comprehensive discharge planning and home follow-up protocol design ed specifically for elders at risk for poor outcomes after discharge and implemented by advanced practice nurses . MAIN OUTCOME MEASURES Readmissions , time to first readmission , acute care visits after discharge , costs , functional status , depression , and patient satisfaction . RESULTS A total of 363 patients ( 186 in the control group and 177 in the intervention group ) were enrolled in the study ; 70 % of intervention and 74 % of control subjects completed the trial . Mean age of sample was 75 years ; 50 % were men and 45 % were black . By week 24 after the index hospital discharge , control group patients were more likely than intervention group patients to be readmitted at least once ( 37.1 % vs 20.3 % ; P<.001 ) . Fewer intervention group patients had multiple readmissions ( 6.2 % vs 14.5 % ; P = .01 ) and the intervention group had fewer hospital days per patient ( 1.53 vs 4.09 days ; P<.001 ) . Time to first readmission was increased in the intervention group ( P<.001 ) . At 24 weeks after discharge , total Medicare reimbursements for health services were about $ 1.2 million in the control group vs about $ 0.6 million in the intervention group ( P<.001 ) . There were no significant group differences in post-discharge acute care visits , functional status , depression , or patient satisfaction . CONCLUSIONS An advanced practice nurse-centered discharge planning and home care intervention for at-risk hospitalized elders reduced readmissions , lengthened the time between discharge and readmission , and decreased the costs of providing health care . Thus , the intervention demonstrated great potential in promoting positive outcomes for hospitalized elders at high risk for rehospitalization while reducing costs BACKGROUND Few investigators have targeted elderly patients and monitored outcomes of care in studies on discharge planning interventions after critical illness . OBJECTIVES To pilot test an intensive care unit-based nursing screening intervention to assist in determining the discharge needs and outcomes of critically ill elderly patients . METHOD A r and omized clinical trial with in-hospital and mailed question naires was used . Patients 65 years and older who were hospitalized in 1 of 2 intensive care units at 2 midwestern university-affiliated medical centers were recruited for the study .  Control patients ( n = 53 ) received usual discharge planning , experimental patients ( n = 47 ) were screened in the intensive care unit by using the Discharge Planning Question naire . Both groups were assessed for readiness for discharge when discharged from the hospital and were followed up 2 weeks later with a survey completed at home . RESULTS One hundred patients 65 to 90 years old ( mean 73 , SD 5.78 ) completed the study . Sixty-six percent were men . The 2 groups did not differ with regard to age , race , sex , severity of illness , lengths of stay in the intensive care unit or hospital , education level , or income . Patients in the experimental group were more ready than patients in the control group for discharge ( P = .06 ) . Patients in the experimental group were also more likely to report they had adequate information , had less concern about managing their care at home , knew their medicines , and knew danger signals indicating potential complications . CONCLUSION Intensive care unit-based early discharge planning can affect elderly patients ' preparation for discharge A multifaceted intervention was hypothesized to increase postdischarge ambulatory contacts and to reduce nonelective readmissions .  Patients ( N=1,001 ) discharged from the general medicine service were stratified by risk for nonelective readmission and r and omized to the control or intervention group . Intervention patients received phone calls from nurses , mailings of appointment reminders and lists of early warning signs , and prompt rescheduling of visit failures . Patients were followed for 6 months , and the results were computed in units per patient per month . The intervention group had 10.4 % more total office contacts ( 0.53 vs 0.48 , P=0.005 ) than the control group . Although the intervention group had 7.6 % fewer nonelective readmission days ( 0.85 vs 0.92 ) , this was not statistically significant ( P=0.5 ) . Patients in the intervention group at high risk ( N=181 ) had 28.1 % more office visits ( 0.73 vs 0.57 , P<0.01 ) and 31.9 % fewer nonelective readmission days ( 1.13 vs 1.66 ) , but this was also not statistically significant ( P=0.06 ) . Thus , the intervention significantly increased postdischarge contacts , primarily in high-risk patients , but failed to reduce the incidence of nonelective readmission days significantly Objective Heart failure patients are regularly admitted to hospital and frequently use multiple medication . Besides intentional changes in pharmacotherapy , unintentional changes may occur during hospitalisation . The aim of this study was to investigate the effect of a clinical pharmacist discharge service on medication discrepancies and prescription errors in patients with heart failure . Setting A general teaching hospital in Tilburg , the Netherl and s. Method An open r and omized intervention study was performed comparing an intervention group , with a  control group receiving regular care by doctors and nurses .  The clinical pharmacist discharge service consisted of review of discharge medication , communicating prescribing errors with the cardiologist , giving patients information , preparation of a written overview of the discharge medication and communication to both the community pharmacist and the general practitioner about this medication . Within 6 weeks after discharge all patients were routinely scheduled to visit the outpatient clinic and medication discrepancies were measured . Main outcome measure The primary endpoint was the frequency of prescription errors in the discharge medication and medication discrepancies after discharge combined . Results Forty-four patients were included in the control group and 41 in the intervention group . Sixty-eight percent of patients in the control group had at least one discrepancy or prescription error against 39 % in the intervention group ( RR 0.57 ( 95 % CI 0.37–0.88 ) ) . The percentage of medications with a discrepancy or prescription error in the control group was 14.6 % and in the intervention group it was 6.1 % ( RR 0.42 ( 95 % CI 0.27–0.66 ) ) . Conclusion This clinical pharmacist discharge service significantly reduces the risk of discrepancies and prescription errors in medication of patients with heart failure in the 1st month after discharge OBJECTIVES to investigate the effectiveness of a  pharmacy discharge plan  in elderly hospitalized patients . DESIGN r and omized controlled trial . SUBJECTS AND SETTING S we r and omized patients aged 75 years and older on four or more medicines who had been discharged from three acute general and one long-stay hospital to a pharmacy intervention or usual care . INTERVENTIONS the hospital pharmacist developed discharge plans which gave details of medication and support required by the patient . A copy was given to the patient and to all relevant professionals and carers . This was followed by a domiciliary assessment by a community pharmacist . In the control group , patients were discharged from hospital following st and ard procedures that included a discharge letter to the general practitioner listing current medications . OUTCOMES the primary outcome was re-admission to hospital within 6 months . Secondary outcomes included the number of deaths , attendance at hospital outpatient clinics and general practice and proportion of days in hospital over the follow-up period , together with patients ' general well-being , satisfaction with the service and knowledge of and adherence to prescribed medication . RESULTS we recruited 362 patients , of whom 181 were r and omized to each group . We collected hospital and general practice data on at least 91 and 72 % of patients respectively at each follow-up point and interviewed between 43 and 90 % of the study subjects . There were no significant differences between the groups in the proportion of patients re-admitted to hospital between baseline and 3 months or 3 and 6 months . There were no significant differences in any of the secondary outcomes . CONCLUSIONS we found no evidence to suggest that the co-ordinated hospital and community pharmacy care discharge plans in elderly patients in this study influence outcomes Background : Angioplasty is one of the most common methods for treating coronary artery diseases . However , a large number of those undergoing this treatment face psychological problems that negatively affect the quality of their life and recovery . We aim ed to determine the effects of discharge planning on stress , anxiety , and depression in patients undergone percutaneous transluminal coronary angioplasty ( PTCA ) .  Methods : In this r and omized controlled trial , 80 c and i date s for PTCA during January to April 2013 were r and omly assigned to equal experimental and control groups . The patients in the experimental group participated in two training sessions before and after the procedure and an informative booklet was used for their training . These patients were followed by phone during the two weeks after discharge . The depression anxiety stress scale ( DASS-21 ) was completed by all subjects upon admission , at discharge , and one month after discharge . Data were analyzed using SPSS software , version 18 . t test was used as appropriated . Results : The experimental group showed a statistically significant decrease in their stress , anxiety and depression a month after receiving the planned discharge ( P<0.001 ) . Although scores of stress ( P=0.696 ) , anxiety ( P=0.110 ) , depression ( P=0.073 ) of the experimental group did not differ significantly on the day of discharge , the decrease was considerable compared with that of the control group . Conclusion : Using a planned discharge program in patients undergoing PTCA lowered their stress , anxiety , and depression . Trial Registration Number : I RCT Background Despite growing emphasis on transitional care to reduce costs and improve quality , few studies have examined transitional care improvements in socioeconomically disadvantaged adults . It is important to consider these patients separately as many are high-utilizers , have different needs , and may have different responses to interventions . Objective To evaluate the impact of a multicomponent transitional care improvement program on 30-day readmissions , emergency department ( ED ) use , transitional care quality , and mortality . Design Clustered r and omized controlled trial conducted at a single urban academic medical center in Portl and , Oregon . Participants Three hundred eighty-two hospitalized low-income adults admitted to general medicine or cardiology who were uninsured or had public insurance . InterventionMulticomponent intervention including ( 1 ) transitional nurse coaching and education , including home visits for highest risk patients ; ( 2 ) pharmacy care , including provision of 30 days of medications after discharge for those without prescription drug coverage ; ( 3 ) post-hospital primary care linkages ; ( 4 ) systems integration and continuous quality improvement . Measurements Primary outcomes included 30-day inpatient readmission and ED use . Readmission data were obtained using state-wide administrative data for all participants ( insured and uninsured ) . Secondary outcomes included quality ( 3-item Care Transitions Measure ) and mortality . Research staff administering question naires and assessing outcomes were blinded . Results There was no significant difference in 30-day readmission between C-TraIn ( 30/209 , 14.4 % ) and control patients ( 27/173 , 16.1 % ) , p = 0.644 , or in ED visits between C-TraIn ( 51/209 , 24.4 % ) and control ( 33/173 , 19.6 % ) , p = 0.271 . C-TraIn was associated with improved transitional care quality ; 47.3 % ( 71/150 ) of C-TraIn patients reported a high quality transition compared to 30.3 % ( 36/119 ) control patients , odds ratio 2.17 ( 95 % CI 1.30–3.64 ) . Zero C-TraIn patients died in the 30-day post-discharge period compared with five in the control group ( unadjusted p = 0.02 ) . Conclusions C-TraIn did not reduce 30-day inpatient readmissions or ED use ; however , it improved transitional care quality A recent federal law has exp and ed the eligibility for multidisciplinary evaluation and assessment of infants suspected of developmental delay . At the same time , modern neonatal care has increased infant survival . These two developments have created a need for family education regarding the need for health and developmental intervention , as well as counseling to maintain family participation in these services . This study compares the education and counseling services of a hospital-based case management team with the traditional discharge and follow-up services of a neonatal intensive care unit ( NICU ) .  Subjects were the 10 % most medically severe infants discharged from a neonatal intensive care unit over a 16-month period . Preliminary data suggests a significantly greater number of families accessed community-based , coordinated , comprehensive health and developmental services when they 
    Output:
    
A discharge plan tailored to the individual patient probably brings about a small reduction in hospital length of stay and reduces the risk of readmission to hospital at three months follow-up for older people with a medical condition .
Discharge planning may lead to increased satisfaction with healthcare for patients and professionals .
There is little evidence that discharge planning reduces costs to the health service