Outpatient follow-up within 30 days of discharge was associated with a reduced risk of 30-day all-cause readmission compared to no follow-up (RRR 0.68; 95% CI 0.60-0.75).
Meta-Analysis
Does outpatient follow-up within 30, 14, and 7 days postdischarge reduce 30-day all-cause readmissions in adult inpatients?
Outpatient follow-up within 30 days is associated with reduced 30-day readmissions, with the greatest benefit seen in targeted high-risk groups such as patients aged 65 years or older with heart failure or acute myocardial infarction.
Effect estimate: RRR 0.68 (95% CI 0.60-0.75)
Importance: Outpatient follow-up after discharge has been associated with reduced 30-day readmissions. Since universal follow-up is not feasible, identifying for whom and when outpatient follow-up is most beneficial is essential for optimizing resources and reducing readmissions. Objective: To quantify the association between outpatient follow-up within 30, 14, and 7 days postdischarge and 30-day all-cause readmissions and assess differences in outcomes by disease, age, and baseline readmission risk. Data Sources: MEDLINE (via PubMed), Embase, and CINAHL were searched for studies published between January 1, 2000, and August 4, 2025, using terms related to outpatient follow-up and readmissions. Study Selection: English-language studies assessing the association between outpatient follow-up within 30 days of hospital discharge and 30-day all-cause readmissions among adult inpatients were included. Data Extraction and Synthesis: Following Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, 2 reviewers independently screened titles and abstracts. Data were extracted by 1 author and verified by another, and quality assessment was done independently by 2 authors. Main Outcomes and Measures: The primary outcome was all-cause 30-day readmission. Secondary outcomes included all-cause 30-day emergency department (ED) discharge and mortality. Pooled effect sizes (relative risk ratios RRRs) were estimated by disease and age group using multilevel random-effects models. Results: Eighty-three studies were included in the review and 76 in the meta-analysis. Outpatient follow-up within 30 days vs no follow-up was associated with a reduction in risk of 30-day all-cause readmission (RRR, 0.68; 95% CI, 0.60-0.75), with less reduction (RRR, 0.78; 95% CI, 0.67-0.89) when restricted to studies with low to moderate risk of bias (ROB). Among patients with heart failure (HF) and acute myocardial infarction (AMI), the RRRs for 30-day follow-up in studies with low to moderate ROB were 0.65 (95% CI, 0.48-0.83) and 0.56 (95% CI, 0.32-0.80), respectively. Subgroup analysis using studies with low to moderate ROB showed benefits of 30-day follow-up only among patients aged 65 years or older with HF (RRR, 0.65; 95% CI, 0.48-0.83), AMI (RRR, 0.56; 95% CI, 0.32-0.80), and other diseases such as stroke and chronic obstructive pulmonary disease (RRR, 0.73; 95% CI, 0.59-0.87). Early follow-up vs no follow-up within 14 and 7 days was associated with a significant reduction in readmissions only among patients aged 65 years or older with HF (14 days: RRR, 0.63 95% CI, 0.40-0.87; 7 days: RRR, 0.68 95% CI, 0.47-0.89) and AMI (14 days: RRR, 0.57 95% CI, 0.22-0.91; 7 days: RRR, 0.63 95% CI, 0.34-0.92). Conclusions and Relevance: In this systematic review and meta-analysis, outpatient follow-up within 30 days was associated with reduced 30-day readmissions, but the association varied by patient age and disease type, indicating a need for targeted rather than universal follow-up.
Balasubramanian et al. (Tue,) conducted a meta-analysis in Adult inpatients. Outpatient follow-up vs. No follow-up was evaluated on all-cause 30-day readmission (RRR 0.68, 95% CI 0.60-0.75). Outpatient follow-up within 30 days of discharge was associated with a reduced risk of 30-day all-cause readmission compared to no follow-up (RRR 0.68; 95% CI 0.60-0.75).