Optimal Timing of Physician Visits after Hospital Discharge to Reduce Readmission

Health Services Research
Bruno D RiverinPatricia Li

Abstract

To identify the optimal timing of in-person physician visit after hospital discharge to yield the largest reduction in readmission among elderly or chronically ill patients. We extracted insurance billing data on 620,656 admissions for any cause from 2002 to 2009 in Quebec, Canada. We used flexible survival models to estimate inverse probability weights for the precise timing (days) of in-person physician visit after discharge and weighted competing risk outcome models. Readmission reduction associated with in-person physician visits (compared to none) was seen early after discharge, with 67.8 fewer readmissions per 1,000 discharges if physician visit occurred within 7 days (95 percent CI: 66.7-69.0), and 110.0 fewer readmissions within 21 days (95 percent CI: 108.2-111.7). The period of largest contribution to readmission reduction was seen in the first 10 days, while physician visits occurring later than 21 days after discharge did not further contribute to reducing hospital readmissions. Larger risk reductions were observed among patients in the highest morbidity level and for in-person follow-up with a primary care physician rather than a medical specialist. When provided promptly, postdischarge in-person physician visit ca...Continue Reading

References

Apr 1, 1994·American Journal of Public Health·A L ReisingerA Schwartz
Feb 24, 1999·JAMA : the Journal of the American Medical Association·M D NaylorJ S Schwartz
Mar 26, 1999·Health Affairs·B A Weisbrod, C L LaMay
Apr 17, 2004·Journal of the American Geriatrics Society·Mary D NaylorJ Sanford Schwartz
Jun 27, 2008·Journal of Clinical Nursing·Susan K Y ChowRance P L Lee
Aug 7, 2008·American Journal of Epidemiology·Stephen R Cole, Miguel A Hernán
May 6, 2010·JAMA : the Journal of the American Medical Association·Adrian F HernandezLesley H Curtis
Jun 26, 2010·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Gregory J MiskyEric A Coleman
Apr 16, 2011·Pediatric Blood & Cancer·John LeschkeDavid C Brousseau
Aug 24, 2011·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Carl van WalravenAlan J Forster
Sep 3, 2011·Journal of the American Geriatrics Society·Caroline Y LinHoward B Degenholtz
Jan 2, 2013·Annals of Internal Medicine·Yong WangHongbin Song
Jan 9, 2013·Pharmacoepidemiology and Drug Safety·Christina DeFilippo MackTil Stürmer
Feb 7, 2013·BMC Medical Research Methodology·Sally R Hinchliffe, Paul C Lambert
Jul 31, 2013·American Journal of Medical Quality : the Official Journal of the American College of Medical Quality·Mai HubbardDominick Esposito
Aug 21, 2013·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Finlay A McAlisterCarl van Walraven
Oct 29, 2013·Annual Review of Medicine·Sunil KripalaniEduard E Vasilevskis
Jan 5, 2014·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Juan LiHuimin Zhai
May 2, 2014·Health Services Research·Melissa M GarridoMelissa D Aldridge
May 9, 2014·Journal of the American Society of Nephrology : JASN·Kevin F EricksonJay Bhattacharya
Jul 31, 2014·JAMA Surgery·Benjamin S BrookePhilip P Goodney
Aug 8, 2014·Current Aging Science·Charlotte Kirk
Nov 8, 2014·PloS One·Claudia FischerEwout W Steyerberg
Mar 11, 2015·Annals of Family Medicine·Carlos JacksonC Annette DuBard
Jun 10, 2015·Population Health Management·Russell OlsenRichard Hodach
Jun 11, 2015·Scandinavian Journal of Primary Health Care·Lau Caspar ThygesenUNKNOWN Prevention of Early Readmission Research Group
Sep 14, 2015·JACC. Heart Failure·Harolyn BakerScott L Hummel

❮ Previous
Next ❯

Citations

Dec 15, 2020·International Journal of Circumpolar Health·Josée LavoieAlan Katz
Oct 31, 2020·Journal of the American Medical Directors Association·Adam SimningHelena Temkin-Greener
Feb 27, 2021·Journal of the American Geriatrics Society·Claire Godard-SebillotteIsabelle Vedel
Apr 30, 2021·Journal of Aging and Health·Adam SimningYeates Conwell

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.