Hospital readmissions are costly and often preventable. Yet, few randomized clinical trials have examined the effects of transitional care interventions on hospital readmissions and other patient-relevant outcomes. A multicenter randomized clinical trial was undertaken to determine whether a transitional care intervention targeting higher-risk patients could reduce the risk of a 30-day unplanned readmission or death.

A total of 1,386 patients discharged from the general medical units of four teaching hospitals who were at higher risk for unplanned readmissions were randomized to either the intervention-consisting of medication reconciliation, patient education, a planned follow-up visit, and two postdischarge telephone calls-or a control group, in which patients received usual care from their hospitalist and a one-page study information sheet.

The primary composite outcome, which was the number of patients discharged alive who had an unplanned readmission or died from any cause within 30 days of discharge, occurred in similar numbers of patients in the intervention and control groups: 145 (21%) and 134 (19%), respectively. The intention-to-treat analysis risk difference was 1.7%. There were no significant differences between groups in health care use, patient satisfaction, or readmission costs.

Among the limitations of the study were that it was single-blind, follow-up was limited to 30 days, and some components of the intervention weren't fully standardized.