Kashiwagi Deanne T, Burton M Caroline, Kirkland Lisa L, Cha Steven, Varkey Prathibha
Mayo Clinic, Rochester, MN, USA.
Am J Med Qual. 2012 Jan-Feb;27(1):11-5. doi: 10.1177/1062860611409197. Epub 2011 Aug 10.
It is widely believed that timely follow-up decreases hospital readmissions; however, the literature evaluating time to follow-up is limited. The authors conducted a retrospective analysis of patients discharged from a tertiary care academic medical center and evaluated the relationship between outpatient follow-up appointments made and 30-day unplanned readmissions. Of 1044 patients discharged home, 518 (49.6%) patients had scheduled follow-up ≤14 days after discharge, 52 (4.9%) patients were scheduled ≥15 days after discharge, and 474 (45.4%) had no scheduled follow-up. There was no statistical difference in 30-day readmissions between patients with follow-up within 14 days and those with follow-up 15 days or longer from discharge (P = .36) or between patients with follow-up within 14 days and those without scheduled follow-up (P = .75). The timing of postdischarge follow-up did not affect readmissions. Further research is needed to determine such factors and to prospectively study time to outpatient follow-up after discharge and the decrease in readmission rates.
人们普遍认为及时随访可降低医院再入院率;然而,评估随访时间的文献有限。作者对一家三级医疗学术医学中心出院的患者进行了回顾性分析,并评估了安排的门诊随访预约与30天内非计划再入院之间的关系。在1044例出院回家的患者中,518例(49.6%)患者在出院后≤14天安排了随访,52例(4.9%)患者在出院后≥15天安排了随访,474例(45.4%)患者未安排随访。出院后14天内随访的患者与出院后15天或更长时间随访的患者之间30天再入院率无统计学差异(P = 0.36),出院后14天内随访的患者与未安排随访的患者之间也无统计学差异(P = 0.75)。出院后随访时间不影响再入院率。需要进一步研究以确定此类因素,并前瞻性地研究出院后门诊随访时间及再入院率的降低情况。