Timely Postdischarge Appointment Reduced Readmissions, ED Visits

Patients with active cancer who received timely and early postdischarge medical oncology follow-up had lower rates of all-cause 30-day readmission and emergency department (ED) visits, according to a retrospective study.

“Readmissions and ED visits account for significant healthcare spending, with the Center for Medicare and Medicaid Services estimating $17 billion US dollars spent annually for rehospitalizations,” wrote Jenny Xiang, MD, of Yale School of Medicine, and colleagues. “Reducing healthcare utilization in the form of readmissions and ED visits has been a priority for legislation and payment models. A timely postdischarge follow-up appointment fits in this paradigm by facilitating inpatient to outpatient care transition, which involves unique providers and communication needs.”

Xiang and colleagues conducted an observational, retrospective, single-center study of 25,135 medical oncology admissions at Yale New Haven Hospital from 2018 to 2020. The study included patients with active cancer who had medical oncology follow-up after hospital discharge.

The researchers conducted propensity score-matched analyses controlling for patient, disease, and admission characteristics, as well as subgroup analyses of five cancer types with the most admissions.

A little more than half (58%) of admissions had a medical oncology appointment within 30 days of discharge; of these, 23.8% had an appointment within 14 days.

Compared with admissions without appointment within 30 days, admissions with postdischarge medical oncology appointment within 30 days had significantly lower rates of all-cause 30-day readmission (odds ratio [OR]=0.56; 95% CI, 0.52-0.59; P<.001) and ED visits (OR=0.56; 95% CI, 0.52-0.59; P<.001).

Admissions with follow-up appointment within 14 days or less were associated with lower-rates of 30-day readmission (OR=0.28; P<.001) and ED visit (OR=0.56; P<.001) compared with appointments from day 15-30.

“These associations were noted in the propensity score–matched cohorts that controlled for patient and admission variables and in the subgroup analysis of the five disease teams with the most admissions,” the researchers wrote.

Reference

Association Between Postdischarge Medical Oncology Follow-up Appointments and Downstream Health Care Use: A Single-Institution Experience