The objective of this systematic review of the literature was to synthesise secondary evidence for hospital avoidance and discharge programs, compared with usual hospital care. Seventeen electronic databases were searched to identify relevant secondary peer-reviewed and grey research. Forty-eight publications were included. Generally, evidence for safety, effectiveness and efficiency of hospital avoidance and discharge programs was equivocal, while there was encouraging evidence regarding improved patient-centred outcomes with most hospital avoidance and discharge planning interventions.