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If You Book It, Will They Come? Attendance at Postdischarge Follow‐Up Visits Scheduled by Inpatient Providers
Author(s) -
Banerjee Rahul,
Suarez Alex,
Kier Melanie,
Jr. Steve Honeywell,
Feng Weiwei,
Mitra Nandita,
Grande David T.,
Myers Jennifer S.
Publication year - 2017
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.12788/jhm.2777
Subject(s) - medicine , confidence interval , quartile , odds ratio , emergency medicine , attendance , incidence (geometry) , hospital medicine , rate ratio , health care , pediatrics , physics , optics , economics , economic growth
BACKGROUND Postdischarge follow‐up visits (PDFVs) are widely recommended to improve inpatient‐outpatient transitions of care. OBJECTIVE To measure PDFV attendance rates. DESIGN Observational cohort study. SETTING Medical units at an academic quaternary‐care hospital and its affiliated outpatient clinics. PATIENTS Adult patients hospitalized between April 2014 and March 2015 for whom at least 1 PDFV with our health system was scheduled. Exclusion criteria included nonprovider visits, visits cancelled before discharge, nonaccepted health insurance, and visits scheduled for deceased patients. MEASUREMENTS The study outcome was the incidence of PDFVs resulting in no‐shows or same‐day cancellations (NS/SDCs). RESULTS Of all hospitalizations, 6136 (52%) with 9258 PD‐FVs were analyzed. Twenty‐five percent of PDFVs were NS/SDCs, 23% were cancelled before the visit, and 52% were attended as scheduled. In multivariable regression models, NS/SDC risk factors included black race (odds ratio [OR] 1.94, 95% confidence interval [CI], 1.63‐2.32), longer lengths of stay (hospitalizations ≥15 days: OR 1.51, 95% CI, 1.22‐1.88), and discharge to facility (OR 2.10, 95% CI, 1.70‐2.60). Conversely, NS/SDC visits were less likely with advancing age (age ≥65 years: OR 0.39, 95% CI, 0.31‐0.49) and driving distance (highest quartile: OR 0.65, 95% CI, 0.52‐0.81). Primary care visits had higher NS/SDC rates (OR 2.62, 95% CI, 2.03‐3.38) than oncologic visits. The time interval between discharge and PDFV was not associated with NS/SDC rates. CONCLUSIONS PDFVs were scheduled for more than half of hospitalizations, but 25% resulted in NS/SDCs. New strategies are needed to improve PDFV attendance.