Post-discharge Follow-up Characteristics Associated With 30-Day Readmission After Heart Failure Hospitalization.
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.
Lee, KK; Yang, J; Hernandez, AF; Steimle, AE; Go, AS
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