Evidence Summary

What is an Evidence Summary?

Key messages from scientific research that's ready to be acted on

Got It, Hide this
  • Rating:

Homecare services delivered to patients with chronic heart failure (CHF) reduce hospitalizations and emergency room visits, improve patient quality of life, and lead to net health system savings

Fergenbaum J, Bermingham S, Krahn M, et al.  Care in the home for the management of chronic heart failure: Systematic review and cost-effectiveness analysis  Journal of Cardiovascular Nursing. 2015 February.

Review question

Do homecare services delivered to patients with chronic heart failure (CHF) lead to improved clinical outcomes and health system cost savings?


A growing number of patients are being diagnosed with CHF, leading to functional limitations, fatigue and shortness of breath. Patients with CHF are at high risk of heart complications and may frequently visit hospitals and emergency rooms.

Services delivered in patients’ homes can include nurse-led education to support self-care and rehabilitation, and support for informal caregivers.

Homecare services for patients with CHF are a promising means of reducing hospital and emergency room visits, and improving patient health outcomes and quality of life, while also leading to health system cost savings.

How the review was done

A number of electronic databases were searched for studies published between January 2006 and January 2012, and those that focused on evaluating the effectiveness of homecare services delivered to patients with CHF were included in the review.

A total of 1,277 studies were identified in searches, and six were included in the review after assessments for eligibility.

This review was funded by Health Quality Ontario.

What the researchers found

CHF patients receiving homecare services experienced fewer hospitalizations, fewer emergency department visits, and higher quality of life compared with patients receiving usual care.

In total, this review estimates that homecare services resulted in a net health system savings of $10,665 per patient. Most of the cost savings came as a result of having fewer hospitalizations.

CHF patients experienced larger than average improvements in quality of life after receiving homecare services, compared with usual care.


This review found that homecare services delivered to patients with CHF reduced patient hospitalizations and emergency room visits, and improved patient quality of life. Home-care services were also found to save the health system money, and improve patient quality of life, suggesting that implementing homecare services for patients with CHF could be more effective and less costly than usual care.

This summary is based on a review that was determined to be of medium methodological quality based on an assessment using the AMSTAR tool.



The body's network of blood vessels. It includes the arteries, veins, and capillaries that carry blood to and from the heart.

Related Web Resources

  • Dementia in long-term care

    Canadian Institute for Health Information
    Older adults with dementia may need to move into long-term care homes if they can no longer stay at home. These people have higher risk of getting physically restrained or given antipsychotic medication. Changes to policy and education have made these things happen less often.
  • Treating pressure ulcers: New evidence, continued uncertainty

    Evidently Cochrane
    Gauze dressings should not be used to treat pressure ulcers (bed sores). Other options include alginate dressings, hydrogel dressings, and negative pressure wound therapy. More evidence is needed about which options are best to improve pain and reduce complications. Research should measure outcomes that matter to patients and carers as well as health professionals.
  • Patient education: Delirium (Beyond the Basics)

    UpToDate - patient information
    Delirium is the result of brain changes that lead to confusion, lack of focus and memory problems. There is no specific treatment for delirium - it is best to avoid risks, treat underlying illnesses and receive supportive care. Sedatives and physical restraints should be avoided.
DISCLAIMER These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Register for free access to all Professional content

Want the latest in aging research? Sign up for our email alerts.

Support for the Portal is largely provided by the Labarge Optimal Aging Initiative. AGE-WELL is a contributing partner. Help us to continue to provide direct and easy access to evidence-based information on health and social conditions to help you stay healthy, active and engaged as you grow older. Donate Today.

© 2012 - 2020 McMaster University | 1280 Main Street West | Hamilton, Ontario L8S4L8 | +1 905-525-9140 | Terms Of Use