Physician follow-up within 30 days of discharge was associated with lower 180-day psychiatric readmission compared to no follow-up (e.g., PCP only: 22% vs 26%; aHR 0.88; 95% CI 0.81-0.96).
Cohort (n=19,132)
Yes
Does physician follow-up within 30 days after hospital discharge reduce psychiatric readmission in the subsequent 180 days in inpatients with schizophrenia?
Timely physician follow-up within 30 days of discharge is associated with a reduced risk of psychiatric readmission in patients with schizophrenia, particularly those at high risk.
Effect estimate: aHR 0.88 (95% CI 0.81-0.96)
Absolute Event Rate: 22% vs 26%
OBJECTIVE: The study evaluated the association between physician follow-up within 30 days after hospital discharge and psychiatric readmission within the subsequent 180 days. METHODS: Among inpatients with schizophrenia who were discharged between 2007 and 2012 in Ontario (N=19,132), those who had a 30-day follow-up visit with a primary care physician (PCP) only, a psychiatrist only, or both were compared with a no-follow-up group. The primary outcome was psychiatric readmission in the subsequent 180 days. Secondary analyses stratified the sample on the basis of readmission risk at discharge. RESULTS: About 65% of patients had follow-up care within 30 days postdischarge. Psychiatric readmission rates were similar among patients with any physician follow-up and significantly lower than among those with no follow-up (26%): PCP only: 22%; adjusted hazard ratio aHR=.88, 95% confidence interval CI=.81-.96; psychiatrist only, 22%; aHR=.84, CI=.77-.90; both, 21%, aHR=.82, CI=.75-.90). In stratified analyses, 66% of patients were in the category at highest risk of psychiatric readmission, and the effect of follow-up with any physician was significant for these patients, compared with high-readmission risk patients with no follow-up, who had a 29% readmission rate (PCP only, 20% readmission rate, aHR=.85, CI=.77-.94; psychiatrist only, 29%, aHR=.84, CI=.77-.92; both, 17%, aHR=.81, CI=.73-.90). DISCUSSION: Timely physician follow-up was associated with reduced risk of psychiatric readmissions, with the greatest reduction among patients at high risk of readmission. Because more than one-third of patients had no physician visit within 30 days postdischarge, improving physician follow-up may help reduce psychiatric readmission rates.
Kurdyak et al. (Fri,) conducted a cohort in Schizophrenia (n=19,132). Physician follow-up within 30 days (PCP, psychiatrist, or both) vs. No follow-up was evaluated on Psychiatric readmission in the subsequent 180 days (aHR 0.88, 95% CI 0.81-0.96). Physician follow-up within 30 days of discharge was associated with lower 180-day psychiatric readmission compared to no follow-up (e.g., PCP only: 22% vs 26%; aHR 0.88; 95% CI 0.81-0.96).