Supplementary Material

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The aims of the systematic review and meta-analysis were to explore the health outcomes and participation in cardiac rehabilitation of patient navigators for the heart failure during the transition period.

PubMed, Embase, CINAHL, and the Cochrane Central Register of Controlled Trials and Chinese Electronic Periodical Services were searched up to September 2020, and the reference lists of relevant articles were also checked. We included randomized controlled trials and cohort studies to evaluate the effectiveness of a heart failure patient navigator program compared to usual care. Two reviewers reviewed the literature independently for eligibility,methodological quality, and extracted outcome data for the meta-analysis. Seven articles were recruited for eligibility after screening, including six randomized controlled trials and one cohort study.

The results of the analysis showed that the 30-days readmission rate was not significantly different, but through subgroup analysis, the intervention group had a higher readmission rate in patients ≤ 60 years old (OR = 2.37, 95% CI [1.47, 3.84], p = .0004). The patient navigator group had higher cardiac rehabilitation enrollment (OR = 2.61, 95% CI [1.05, 6.47], p = .04), hospital-based utilization (95% CI -0.21 [-0.41, -0.01]), and health care cost ($5,676 vs. $7,640; p = 0.03) were significantly lower.

The results suggest that patient navigators may promote cardiac rehabilitation enrollment and reduce hospital-based utilization and health care costs. The younger patients were at high risk of readmission during the transition period and may require novel strategies.