Efficacy of a Transition Clinic on Hospital Readmissions.
Am J Med. 2017 Sep 20;:
Authors: Chakravarthy V, Ryan MJ, Jaffer A, Golden R, McClenton R, Kim J, Press I, Johnson T
Abstract
BACKGROUND: A primary care staffed transition clinic is one potential strategy for reducing thirty-day readmissions for patients without an established primary care physician, but the effectiveness has not been studied. The objective was to test whether patients who completed a post-discharge transition clinic appointment were less likely to be readmitted within thirty days.
METHODS: This retrospective cross-sectional study included adults with Medicare and Medicaid coverage who were discharged from general medicine units at Rush University Medical Center between October 2013 and October 2014. All patients had a follow-up appointment scheduled within thirty days of discharge in either the transition clinic or with their primary care physician. A binary logistic regression model was constructed to test the relationship between thirty-day readmission and follow-up appointment status, controlling for patient factors.
RESULTS: The sample included 1,149 patients with scheduled follow-up appointments (24% in the transition clinic and 76% with their primary care physician). After controlling for patient demographic characteristics and clinical factors, patients who did not complete a scheduled transition clinic appointment had nearly three times higher odds of readmission compared with patients who completed a transition clinic appointment (Adjusted Odds Ratio 2.80, p = 0.004). There was no significant difference in the likelihood of thirty-day readmission between patients completing a transition clinic appointment and those who were scheduled with their primary care physician.
CONCLUSION: A primary care staffed transition clinic is a promising strategy for providing access after a recent hospitalization and effectively managing the initial post-hospital discharge needs of vulnerable populations.
PMID: 28941749 [PubMed - as supplied by publisher]