Post-Discharge Services Associated With Reduced Readmissions and Costs

Institutional outpatient care, home health care, and primary care physician visits after discharge from an index admission (IA) are associated with reduced readmission rates, length of stay (LOS), and costs, a new Journal of General Internal Medicine study shows.

Researchers sought to investigate the association between unplanned 30-day readmission, LOS, and inpatient costs, and different post-discharge services administered at 7-, 14-, and 30-day intervals.

The study evaluated outcomes for 7 types of post-discharge services including institutional outpatient, primary care physician, specialist, non-physician provider, emergency department (ED), home health care, and skilled nursing facility. Participants included 583,199 all-cause IAs from 2014 Medicare fee-for-service beneficiaries that met IA inclusion criteria.

The probability of unplanned 30-day readmission was 0.1176, average readmission LOS was 0.67 days, and average cost was $5648.

Researchers found that these rates decreased with utilization of institutional outpatient, home health care, and primary care physician visits at all time intervals. Specialist visits were associated with an increase in all outcomes at 7 and 14 days but a decrease at 30 days, and ED visits were “strongly associated” with increases no matter the time interval.

Post-discharge services’ varied impact on readmission, LOS, and costs should be taken into consideration when providers coordinate post-discharge follow up, although more research is needed to understand the driving factors behind these findings, the study noted.

Reference:
Tak HJ, Goldsweig AM, Wilson FA, et al. Association of post-discharge service types and timing with 30-day readmissions, length of stay, and costs [published online ahead of print May 13, 2021]. J Gen Intern Med. 2021;10.1007/s11606-021-06708-6. doi:10.1007/s11606-021-06708-6