Timeliness in discharge summary dissemination is associated with patients' clinical outcomes. Issue 1 (17th October 2011)

• Record Type: Journal Article
• Authors: Li, Jordan Y. Z.; Yong, Tuck Y.; Hakendorf, Paul; Ben‐Tovim, David; Thompson, Campbell H.
• Is Part Of: Journal of evaluation in clinical practice. Volume 19:Issue 1(2013)
• Page Start: 76
• Page End: 79
• Publication Date: 2011-10-17
• Subjects: discharge summary -- general medicine -- readmission rate; Clinical medicine -- Periodicals; 616.005
• DOI: 10.1111/j.1365-2753.2011.01772.x
• Languages: English
• ISSNs: 1356-1294

Abstract

Abstract: Rationale, aims and objectives To determine the relation of the readmission rate of general medical patients to either the existence of a discharge summary or the timeliness of its dispatch. Methods This was a retrospective study on discharge summaries of all discharges from the general medical service at a tertiary referral teaching hospital from January 2005 to December 2009. The main outcome measures were readmission rate to hospital within 7 or 28 days of discharge Results A total of 16 496 patient admissions were included in the analysis. Of these discharges, 3397 (20.6%) patients did not have a summary completed within a week of discharge. There were significant linear trends between patients' readmission rates within 7 ( P < 0.001) or 28 days ( P < 0.001) and categories reflecting the delay in dispatch of their discharge summaries. The absence of a discharge summary was associated with a 79% increase in the rate of readmission within 7 days [95% confidence interval (CI) 42 to 124% increase; P < 0.001] and a 37% increased rate of readmission within 28 days (95% CI 17 to 61% increase; P < 0.001). If aged less than 80 years, the absence of a discharge summary was associated with a 127% increase in readmission rate within 7 days (95% CI 72 to 202% increase; P < 0.001) and a 55% increase within 28 days (95% CI 25 to 91% increase; P < 0.001) after discharge. Conclusions Delayed transmission or absence of a discharge summary is associated with readmission of the patient; more so in patients less than 80 years old. If no summary is generated by 7 days after discharge, the rate of readmission within 7 or 28 days after discharge is indistinguishable from no summary being written at all.