Outpatient follow-up visits were significantly associated with a reduced risk of all-cause non-elective 30-day readmissions (adjusted HR 0.86), with the greatest reduction seen for visits within 2 days.
Cohort (n=55,378)
Sí
Does an outpatient follow-up visit reduce all-cause non-elective 30-day readmissions in adult inpatients discharged to home?
Outpatient follow-up visits, particularly within 2 days of discharge, are significantly associated with reduced 30-day readmission risk, especially for patients at high but not extremely high baseline risk.
Estimación del efecto: HR 0.86 (95% CI 0.82-0.91)
Tasa de eventos absoluta: 7.3% vs 18.27%
BACKGROUND: As an effort to reduce hospital readmissions, early follow-up visits were recommended by the Society of Hospital Medicine. However, published literature on the effect of follow-up visits is limited with mixed conclusions. Our goal here is to fully explore the relationship between follow-up visits and the all-cause non-elective 30-day readmission rate (RR) after adjusting for confounders. METHODS AND RESULTS: To conduct this retrospective observational study, we extracted data for 55,378 adult inpatients from Advocate Health Care, a large, multi-hospital system serving a diverse population in a major metropolitan area. These patients were discharged to Home or Home with Home Health services between June 1, 2013 and April 30, 2015. Our findings from time-dependent Cox proportional hazard models showed that follow-up visits were significantly associated with a reduced RR (adjusted hazard ratio: 0.86; 95% CI: 0.82-0.91), but in a complicated way because the interaction between follow-up visits and a readmission risk score was significant with p-value 0.334) saw no RR reduction from follow-up visits. Third, a patient was much more likely to have a 2-day follow-up visit if that visit was scheduled before the patient was discharged from the hospital (30% versus < 5%). CONCLUSIONS: Follow-up visits are associated with a reduction in readmission risk. The timing of follow-up visits can be important: beyond two days, the earlier, the better. The effect of follow-up visits is more significant for patients with a high but not extremely high risk of readmission.
Tong et al. (Tue,) conducted a cohort in Adult inpatients discharged to Home or Home Health (n=55,378). Outpatient follow-up visits vs. No outpatient follow-up visits was evaluated on All-cause non-elective 30-day readmission (HR 0.86, 95% CI 0.82-0.91). Outpatient follow-up visits were significantly associated with a reduced risk of all-cause non-elective 30-day readmissions (adjusted HR 0.86), with the greatest reduction seen for visits within 2 days.
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