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Background Rehospitalizations are common in healthcare. They are costly for hospitals and patients and a substantial percentage are preventable, partly because hospital-to-community transitions are often unmanaged or poorly managed. In this study, we conducted a pragmatic randomized, controlled trial to evaluate the effectiveness of a new nurse–practitioner-led transitional care program called CareHub, piloted in Singapore’s National University Hospital. Methods Study population included all eligible cardiac patients admitted between July 2016 and November 2016. Patients were followed for six months post-discharge. Primary outcomes other than emergency department visits were all cardiac-related: number of readmissions, specialist visits, emergency department visits, and total days readmitted. Secondary outcomes: variables related to quality of life and transitional care. Regression analyses were used to estimate the intent-to-treat effect of CareHub and explore treatment heterogeneity. Results CareHub reduced the mean number of unplanned readmissions by 0.23 (a 39% reduction relative to control mean of 0.60 unplanned readmissions, p < 0.05), mean number of all readmissions by 0.20 (31% reduction relative to control mean of 0.63 readmissions, p = 0.10), mean number of total unplanned days in hospital by 2.2 (56% reduction relative to control mean of 4.0 days, p < 0.05), mean number of total days in hospital by 2.0 (42% reduction relative to control mean of 4.3 days, p < 0.10). Treatment effects varied by pre-admission health and socio-economic status. Conclusion A carefully designed protocolized cardiac hospital-to-home transition program can reduce resource utilization while improving quality of life.

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Non-contributory pensions are becoming increasingly prevalent worldwide. As their effects are likely to be context-dependent, evaluating their effects in a wide range of settings is important for establishing the external validity of the non-contributory pension literature. We use a new monthly panel dataset and a difference-indifferences strategy to study the effect of a new non-contributory pension in Singapore (the Silver Support Scheme or SSS) on labour supply, work expectations, private cash transfers, and expenditure, 1 year after its implementation. We find no evidence that receiving SSS payouts led to a fall in labour supply, work expectations, or the receipt of private cash transfers in the first year after SSS implementation-our estimated effects for these outcomes are statistically insignificant and are either negative but close to zero or positive. Our point estimates of the effects of receiving SSS payouts on expenditure are positive but too imprecise to allow us to make any definitive conclusions. Lastly, we do not find evidence of anticipatory effects among younger individuals who are not ageeligible for payouts yet. These results, when coupled with our finding in a companion paper that the SSS improved recipients' subjective well-being, suggest that the SSS was successful in improving recipients' welfare without substantial crowding out of private transfers or changes in labour market behaviour of current and future SSS beneficiaries.

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