Post-discharge Follow-up Characteristics Associated With 30-Day Readmission After Heart Failure Hospitalization. Issue 4 (April 2016)

• Record Type: Journal Article
• Authors: Lee, Keane K.; Yang, Jingrong; Hernandez, Adrian F.; Steimle, Anthony E.; Go, Alan S.
• Is Part Of: Medical care. Volume 54:Issue 4(2016)
• Publication Date: 2016-04
• Subjects: heart failure readmission -- 30-day readmission -- postdischarge care; Economics, Medical -- Periodicals; Insurance, Health -- Periodicals; Santé, Services de -- Administration -- Périodiques; Soins médicaux -- Périodiques; Medical economics -- Periodicals; Health insurance -- Periodicals; Medical economics -- United States -- Periodicals; Health insurance -- United States -- Periodicals; Comprehensive Health Care -- Periodicals; Personal Health Services -- Periodicals; Gezondheidszorg; Économie de la santé -- Périodiques; Santé, Services de -- Périodiques; Health insurance; Medical economics; United States; Periodicals; 362.10973
• DOI: 10.1097/MLR.0000000000000492
• Languages: English
• ISSNs: 0025-7079

Abstract

Abstract : Background: Readmission within 30 days after hospitalization for heart failure (HF) is a major public health problem. Objective: To examine whether timing and type of post-discharge follow-up impacts risk of 30-day readmission in adults hospitalized for HF. Design: Nested matched case-control study (January 1, 2006–June 30, 2013). Setting: A large, integrated health care delivery system in Northern California. Participants: Hospitalized adults with a primary diagnosis of HF discharged to home without hospice care. Measurements: Outpatient visits and telephone calls with cardiology and general medicine providers in non-emergency department and non-urgent care settings were counted as follow-up care. Statistical adjustments were made for differences in patient sociodemographic and clinical characteristics, acute severity of illness, hospitalization characteristics, and post-discharge medication changes and laboratory testing. Results: Among 11, 985 eligible adults, early initial outpatient contact within 7 days after discharge was associated with lower odds of readmission [adjusted odds ratio (OR)=0.81; 95% CI, 0.70–0.94], whereas later outpatient contact between 8 and 30 days after hospital discharge was not significantly associated with readmission (adjusted OR=0.99; 95% CI, 0.82–1.19). Initial contact by telephone was associated with lower adjusted odds of 30-day readmission (adjusted OR=0.85; 95% CI, 0.69–1.06) but was not statistically significant. Conclusions: In adults discharged to home after hospitalization for HF, outpatient follow-up with a cardiology or general medicine provider within 7 days was associated with a lower chance of 30-day readmission. Abstract : Supplemental Digital Content is available in the text.