Effect of discharge summary availability during post-discharge visits on hospital readmission

Journal of General Internal Medicine
Carl van WalravenAndreas Laupacis

Abstract

To determine if the delivery of hospital discharge summaries to follow-up physicians decreases the risk of hospital readmission. Eight hundred eighty-eight patients discharged from a single hospital following treatment for an acute medical illness. Teaching hospital in a universal health-care system. We determined the date that each patient's discharge summary was printed and the physicians to whom it was sent. Summary receipt was confirmed by survey and phoning each physician's office. Each patient's hospital chart was reviewed to determine their acute and chronic medical conditions as well as their course in hospital. Using population-based administrative databases, all post-hospitalization visits were identified. For each of these visits, we determined whether the summary was available. Time to nonelective hospital readmission during 3 months following discharge. The discharge summary was available for only 568 of 4,639 outpatient visits (12.2%). Overall, 240 (27.0%) of patients were urgently readmitted to hospital. After adjusting for significant patient and hospitalization factors, we found a trend toward a decreased risk of readmission for patients who were seen in follow-up by a physician who had received a summary (rela...Continue Reading

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