Article Figures & Data
Figures
- Figure 1
Time to readmission for patients who did vs did not receive outpatient follow-up within 7 days of discharge: lower risk strata.
Note: Rates vary according to the patient’s underlying clinical risk. Each stratum represents patients in clinical risk groups based on 3M Health Information System’s Clinical Risk Groups and accompanying baseline risk of a 30-day readmission.
- Figure 2
Time to readmission for patients who did vs did not receive outpatient follow-up within 7 days of discharge: higher risk strata.
Note: Rates vary according to the patient’s underlying clinical risk. Each stratum represents patients in clinical risk groups based on 3M Health Information System’s Clinical Risk Groups and accompanying baseline risk of a 30-day readmission.
- Figure 3
Relationship between receipt of outpatient follow-up and risk of readmission.
Incremental risk of a 30-day readmission associated with patients who have not yet received follow-up within 3, 7, 14, 21, and 30 days after discharge, and how that relationship varies according to the patient’s underlying clinical risk. Each of the 7 strata represents patients in clinical risk groups based on 3M Health Information System’s Clinical Risk Groups and accompanying baseline risk of a 30-day readmission.
Tables
Risk Strata (Readmission Risk)a No. of Unique Patients Age, y Mean (SD) Race No. (% White) Sex No. (% Female) No chronic conditions (<10%) 13,212 12.2 (15.1) 6,592 (50.1) 6,892 (52.2) Single chronic conditions (<10%) 8,176 17.3 (16.6) 3,598 (44.0) 4,103 (50.2) Multiple chronic conditions (<10%) 9,705 36.2 (18.7) 5,058 (52.1) 5,937 (61.2) Multiple chronic conditions (10%–19%) 7,114 38.2 (18.6) 3,672 (51.6) 4,211 (59.2) Multiple chronic conditions (20%–29%) 4,135 39.2 (19.2) 2,157 (46.9) 2,227 (53.9) Multiple chronic conditions (30%–39%) 1,570 40.5 (19.6) 736 (37.9) 885 (56.4) Multiple chronic conditions (≥40%) 561 46.2 (16.6) 225 (40.1) 342 (61.0) Total 44,473 26.5 (21.1) 22,038 (49.6) 24,597 (55.3) -
↵a Risk of readmission within 30 days.
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Risk Strata: Follow-up Within Indicated Days Readmission, Receiving Follow-up % Readmission, Not Receiving Follow-up % Difference % P Value No chronic conditions (<10% readmission risk), n = 14,767a 3 d 4.7 5.9 1.2 .004 7 d 5.1 6.0 0.9 .006 14 d 4.9 6.4 1.5 <.001 21 d 4.7 7.0 2.3 <.001 30 d 4.5 7.5 3.0 <.001 Single chronic condition (<10% readmission risk), n= 10,027a 3 d 6.0 6.4 0.4 .511 7 d 6.0 6.6 0.6 .183 14 d 5.8 6.9 1.1 .014 21 d 5.4 7.5 2.1 <.001 30 d 5.1 8.4 3.3 <.001 Multiple chronic conditions (<10% readmission risk), n = 12,777a 3 d 30 8.9 −0.3 .720 7 d 8.9 9.0 0.1 .522 14 d 7.6 10.2 2.6 <.001 21 d 6.8 11.7 4.9 <.001 30 d 6.2 13.8 7.6 <.001 Multiple chronic conditions (10%–19% readmission risk), n = 11,894a 3 d 14.9 15.4 0.5 .387 7 d 14.4 15.8 1.4 .004 14 d 12.5 18.3 5.8 <.001 21 d 11.6 20.9 9.3 <.001 30 d 10.7 24.7 14.0 <.001 Multiple chronic conditions (20%–29% readmission risk), n = 9,018a 3 d 21.5 24.7 3.2 .011 7 d 20.1 26.3 6.2 <.001 14 d 18.5 30.5 12.0 <.001 21 d 17.3 34.8 17.5 <.001 30 d 16.0 40.6 24.6 <.001 Multiple chronic conditions (30%–39% readmission risk), n = 4,552a 3 d 30.1 32.7 2.6 .129 7 d 27.9 34.5 6.6 <.001 14 d 25.0 40.5 15.5 <.001 21 d 24.1 45.0 20.9 <.001 30 d 22.6 51.2 28.6 <.001 Multiple chronic conditions (≥40% readmission risk), n = 2,050a 3 d 40.6 43.0 2.4 .144 7 d 37.4 45.1 7.7 <.001 14 d 32.7 51.8 19.1 <.001 21 d 30.6 58.3 27.7 <.001 30 d 28.9 64.3 35.5 <.001 -
↵a Number of index discharges.
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The Article in Brief
Timeliness of Outpatient Follow-up: An Evidence-Based Approach for Planning After Hospital Discharge
C. Annette DuBard , and colleagues
Background Timely outpatient follow-up is considered key to reducing hospital readmissions. This study looks at the optimal timing of hospital follow-up for patients of varying complexity.
What This Study Found Although most patients do not meaningfully benefit from early outpatient follow-up, high risk patients do. Among patients with up to one chronic or acute condition, readmissions are uncommon, and the timing of outpatient follow-up for up to 30 days has little effect. Among patients with multiple chronic conditions, however, follow-up within 7 days is associated with meaningful reductions in risk of readmission.
Implications
- While healthier patients and those with greater social support or self-management skills may be better equipped to make and attend an earlier follow-up appointment, it can potentially delay care for those with more complex needs.
- The authors suggest that transitional care resources can best be used to ensure that highest risk patients receive follow-up within 7 days.
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