Objective: to investigate the powers of supported discharge after an acute admission in older the public with undifferentiated clinical problems.

Objective: to investigate the powers of supported discharge after an acute admission in older the public with undifferentiated clinical problems. Design: a systematic review of randomized controll trials. Methods: we searched MEDLINE, CINAHL, the Cochrane Library, PsycLit and the Social Science Citation Index up to the close of 1997. This was augmented by the agency of hand-searching, follow-up of bibliographies and direct enquiry of authors of included studies. Application of inclusion decisions, quality assessment and data abstraction were carried gone out independently by at least brace of the reviewers. We tabulated the be the effects of the included studies and used meta-analysis where appropriate to refine conclusions. Results: we finally included nine studies in the review, assessment of which revealed that bias was ready dictating the need for caution in interpreting be deriveds Despite this, there was relative certainty that the proportion of those at hearth 6-12 months after admission is greater with supported discharge (odd ratio 14 95% confidence interval 11 - 20) This was associated with a consistent pattern of reduction in admission to long-stay care athwart the same period, without apparent increases in mortality. There was uncertainty about the event of supported discharge on hospitalization. There were no rigorous research data forward functional status, patient and carer satisfaction, and, in conclusion uncertainty about the overall effectiveness of supported discharge. Conclusions: we believe that the terminates of this review provide reassurance that supporting discharge from hospital to family is of value. However, important sources of uncertainty remain, suggesting the ne for further research.

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