Background: Recurrent hospitalizations are responsible for considerable health care costs. This retrospective observational study was undertaken to determine whether timely communication of care (COC), such as direct phone call or voicemail notice, following a hospitalization is effective at increasing clinic follow-up rates and reducing readmissions within 30 days after discharge.
Methods: We analyzed 237 patients who were hospitalized for high-risk diagnosis at a tertiary medical center with discharge dates between 06/2016 and 05/2017. High risk diagnosis was defined as having gastrointestinal, cardiac, or lower respiratory conditions on admission and required hospital length of stay for 2 days or more. Demographic variables including age, sex, and spoken language were recorded. Patients who received telephone calls comprised the intervention group; all other members who received other forms of COC, or no COC, formed the comparison group. Multiple logistic regression was used to determine the impact of the intervention on clinic follow-up rates and 30-day hospital readmissions, after adjusting for covariates.
Results: Of the 237 eligible discharges, 87 had completed phone conversations, 66 received another form of COC, such as voicemail notices, and 84 had neither. Discharged patients who received phone communications were associated with higher follow-up appointment attendance compared with those who received only voicemail encounters or no COC (82.8%, 69.7%; p < 0.05). There was, however, no significant difference in 30-day hospital readmission rates (10.7%, 10.6%; p > 0.05). Of patients who received COC, timely communication (within 2 weeks after hospital discharge) was associated with significantly lower readmission rates (7.3% with timely COC vs. 17.1% without timely COC; p < 0.05). An analysis of the specific impact of covariates across the entire eligible population demonstrated that readmission rates were positively associated with older age at the time of initial hospitalization, male sex and longer initial hospital length of stays (p < 0.05 for all covariates).
Conclusions: This study reveals the potential impact of timely COC, such as telephone outreach to patients, can have on increasing post-discharge follow-up rates and on reducing hospital readmissions, thereby minimizing the considerable healthcare costs associated with those readmissions.