Key result
A telephone follow-up call within 24 hours of emergency department discharge did not reduce unplanned hospital admissions or ED return visits within 30 days in older adults (OR 1.16).
Why the study?
Telephone follow-up calls could optimize transitions from the ED to home for older patients, but their effects on hospital return rates are not clear.
Does a semi-scripted telephone follow-up call reduce unplanned hospitalizations and/or ED return visits in community-dwelling adults aged ≥70 years discharged from the ED?
RCT (n=3,175)
Open-label (outcome assessors blinded)
Allocation by month (odd months intervention, even months control)
Yes
Does a semi-scripted telephone follow-up call reduce unplanned hospitalizations and/or ED return visits in community-dwelling adults aged ≥70 years discharged from the ED?
Odds Ratio: 1.16 (95% CI 0.96–1.42)
Absolute Event Rate: 16% vs 14%
A post-discharge telephone follow-up call by an ED nurse did not reduce 30-day unplanned hospital returns for older adults discharged from the emergency department.
Should not yet change post-ED discharge care for older adults; leaves open efficacy in larger trials.
BACKGROUND/OBJECTIVES: Telephone follow-up calls could optimize the transition from the emergency department (ED) to home for older patients. However, the effects on hospital return rates are not clear. We investigated whether telephone follow-up reduces unplanned hospitalizations and/or unplanned ED return visits within 30 days of ED discharge. DESIGN: Pragmatic randomized controlled trial with allocation by month; odd months intervention group, even months control group. SETTING: Two ED locations of a non-academic teaching hospital in The Netherlands. PARTICIPANTS: Community-dwelling adults aged ≥70 years, discharged home from the ED were randomized to the intervention group (N = 4732) or control group (N = 5104). INTERVENTION: Intervention group patients: semi-scripted telephone call from an ED nurse within 24 h after discharge to identify post-discharge problems and review discharge instructions. Control group patients: scripted satisfaction survey telephone call. MEASUREMENTS: Primary outcome: total number of unplanned hospitalizations and/or ED return visits within 30 days of ED discharge. SECONDARY OUTCOMES: separate numbers of unplanned hospitalizations and ED return visits. Subgroup analysis by age, sex, living condition, and degree of crowding in the ED at discharge. RESULTS: Overall, 42% were males, and median age was 78 years. In the intervention group, 1516 of 4732 patients (32%) consented, and in the control group 1659 of 5104 (33%) patients. Unplanned 30-day hospitalization and/or ED return visit was found in 16% of intervention group patients and 14% of control group patients (odds ratio 1.16; 95% confidence interval: 0.96-1.42). Also, no statistically significant differences were found in secondary outcome measures. Within the subgroups, the intervention did not have beneficial effects for the intervention group. CONCLUSION: Telephone follow-up after ED discharge in older patients did not result in reduction of unplanned hospital admissions and/or ED return visits within 30 days. These results raise the question of whether other outcomes could be improved by post-discharge ED telephone follow-up.
No takes yet. Share an insight, caveat, or question.
Loon et al. (2021) conducted an RCT in Emergency department discharge (n=3,175). Telephone follow-up call vs. Satisfaction survey telephone call was evaluated on Unplanned hospitalizations and/or ED return visits within 30 days (OR 1.16, 95% CI 0.96-1.42). A telephone follow-up call within 24 hours of emergency department discharge did not reduce unplanned hospital admissions or ED return visits within 30 days in older adults (OR 1.16).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: