Patients with multiple conditions need early outpatient follow-up

(HealthDay)—The timeliness of outpatient follow-up after discharge matters most for patients with multiple chronic conditions and a greater than 20 percent baseline risk of readmission, according to research published in the March/April issue of the Annals of Family Medicine.

Carlos Jackson, Ph.D., of Community Care of North Carolina in Raleigh, and colleagues analyzed data for 44,473 Medicaid recipients with 65,085 qualifying discharges. The authors sought to determine the optimal timing of outpatient follow-up for patients in varying clinical risk groups.

The researchers found that follow-up within 14 days after discharge was associated with a 19.1 percentage point reduction in readmissions for patients in the highest risk strata and a 1.5 percentage point reduction for those in the lowest risk strata (both P < 0.001). Meaningful reductions in risk of readmission were observed for follow-up within seven days for patients with multiple chronic conditions and a greater than 20 percent baseline risk of readmission; this group represented 24 percent of discharged patients.

"Most patients do not meaningfully benefit from early outpatient follow-up," the authors write. "Transitional care resources would be best allocated toward ensuring that highest risk patients receive follow-up within seven days."

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