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. 2014 Oct;156(4):949-56.
doi: 10.1016/j.surg.2014.06.041.

Outpatient follow-up versus 30-day readmission among general and vascular surgery patients: a case for redesigning transitional care

Richard Scott Saunders  1 , Sara Fernandes-Taylor  1 , Paul J Rathouz  2 , Sandeep Saha  2 , Jason T Wiseman  1 , Jeffrey Havlena  1 , Jon Matsumura  1 , K Craig Kent  3
Affiliations

Outpatient follow-up versus 30-day readmission among general and vascular surgery patients: a case for redesigning transitional care

Richard Scott Saunders et al. Surgery. 2014 Oct.

Abstract

Background: The association between early outpatient follow-up and 30-day readmission has not been evaluated in any surgical population. Our study characterizes the relationship between outpatient follow-up and early readmissions among surgical patients.

Methods: We queried the medical record at a large, tertiary care institution (July 2008-December 2012) to determine rates of 30-day outpatient follow-up and readmission for general or vascular operative procedures.

Results: The majority of discharges for general (84% of 7,552) and vascular (75% of 2,362) surgery had a follow-up visit before readmission or within 30 days of discharge. General surgery patients who were not readmitted had high rates of follow-up (88%) and received follow-up at approximately 2 weeks postdischarge (median, 11 days after discharge). In contrast, readmitted general surgery patients received first follow-up at 1 week (median, 8 days); 49% had follow-up. Vascular surgery patients showed a similar trend. More than one half of patients readmitted after follow-up were readmitted within 24 hours of their most recent outpatient visit.

Conclusion: Current routine follow-up does not occur early enough to detect adverse events and prevent readmission. Early outpatient care may prevent readmission in some patients, but often serves as a conduit for readmission among patients already experiencing complications.

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Conflict of interest statement

The other authors declare no relevant conflicts of interest.

Figures

Figure 1
Figure 1
Figure 1.1. Day of First Follow-up by Readmission Status Post-discharge day of first follow-up visit by readmission status for general and vascular surgery patients Figure 1.2. Day of First Follow-up for Readmitted Patients by Time From Discharge to Readmission Post-discharge day of first follow-up visit stratified by days to readmission for general and vascular surgery patients
Figure 1
Figure 1
Figure 1.1. Day of First Follow-up by Readmission Status Post-discharge day of first follow-up visit by readmission status for general and vascular surgery patients Figure 1.2. Day of First Follow-up for Readmitted Patients by Time From Discharge to Readmission Post-discharge day of first follow-up visit stratified by days to readmission for general and vascular surgery patients
Figure 2
Figure 2
Day of First Follow-up Visit by Time Between First Follow-up and Readmission Post-discharge day of first follow-up visit stratified by time between follow-up and readmission for general and vascular surgery patients
Figure 3
Figure 3
Day of First Follow-up vs. Day of Readmission Post-discharge day of first follow-up for not readmitted patients as compared to post discharge day of readmission for readmitted patients
Figure 4
Figure 4
Provider Specialty for First Follow-up Visit Provider specialties for first follow-up visits of general and vascular surgery patients
See this image and copyright information in PMC

Comment in

  • Discussion.
    [No authors listed] [No authors listed] Surgery. 2014 Oct;156(4):956-8. doi: 10.1016/j.surg.2014.06.048. Surgery. 2014. PMID: 25239352 No abstract available.

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