Do timely outpatient follow-up visits decrease hospital readmission rates?
Am J Med Qual. 2012 Jan-Feb;27(1):11-5
Authors: Kashiwagi DT, Burton MC, Kirkland LL, Cha S, Varkey P
Abstract
It is widely believed that timely follow-up decreases hospital readmissions; however, the literature evaluating time to follow-up is limited. The authors conducted a retrospective analysis of patients discharged from a tertiary care academic medical center and evaluated the relationship between outpatient follow-up appointments made and 30-day unplanned readmissions. Of 1044 patients discharged home, 518 (49.6%) patients had scheduled follow-up ?14 days after discharge, 52 (4.9%) patients were scheduled ?15 days after discharge, and 474 (45.4%) had no scheduled follow-up. There was no statistical difference in 30-day readmissions between patients with follow-up within 14 days and those with follow-up 15 days or longer from discharge (P = .36) or between patients with follow-up within 14 days and those without scheduled follow-up (P = .75). The timing of postdischarge follow-up did not affect readmissions. Further research is needed to determine such factors and to prospectively study time to outpatient follow-up after discharge and the decrease in readmission rates.
PMID: 21835809 [PubMed - indexed for MEDLINE]
In this study out of Mayo, risk of 30d readmission was no different among patients with follow-up scheduled within 14 days of discharge, more than 14 days after discharge, or not at all. There was a slightly (not statistically but perhaps clinically significant) increased length of stay among those who followed up within 14 days, which may have negatively affected the readmission rate in the <14 day group (if length of stay is positively correlated with readmission). Furthermore, the demographics of the study population do not reflect national patterns.
Is there enough evidence to support the "discharge clinics" that are becoming so popular among hospitals to prevent early readmission?