Evidence map›Paper›PMID 29766499›Full record

ArticleHealth services research2018

Optimal Timing of Physician Visits after Hospital Discharge to Reduce Readmission.

Bruno D Riverin, Erin C Strumpf, Ashley I Naimi, Patricia Li

Open access · bronzeAbstract read
In one paragraph

Article in Health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 2 pooled it
2.8field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 40 citations in OpenAlex.

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  17. Receipt of Timely Primary Care Services Following Post-Acute Skilled Nursing Facility Care.Journal of the American Medical Directors Association · 2021
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  20. Reframing "No-Show": Patient-Reported Barriers for Missed Post-Hospital Discharge Primary Care Follow-Up Visits.American journal of medical quality : the official journal of the American College of Medical Quality
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 2 countries.

Bruno D RiverinDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.ORCID 0000-0002-4397-4097
Erin C StrumpfDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
Ashley I NaimiDepartment of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.
Patricia LiDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
McGill University Health Centre · CAMontreal Children's Hospital · CAUniversity of Pittsburgh · US

Funding

CIHR
6 · The paper itself

Abstract

objectiveTo identify the optimal timing of in-person physician visit after hospital discharge to yield the largest reduction in readmission among elderly or chronically ill patients. DATA SOURCES/STUDY SETTING/EXTRACTION

methodsWe extracted insurance billing data on 620,656 admissions for any cause from 2002 to 2009 in Quebec, Canada. STUDY

designWe used flexible survival models to estimate inverse probability weights for the precise timing (days) of in-person physician visit after discharge and weighted competing risk outcome models. PRINCIPAL

findingsReadmission reduction associated with in-person physician visits (compared to none) was seen early after discharge, with 67.8 fewer readmissions per 1,000 discharges if physician visit occurred within 7 days (95 percent CI: 66.7-69.0), and 110.0 fewer readmissions within 21 days (95 percent CI: 108.2-111.7). The period of largest contribution to readmission reduction was seen in the first 10 days, while physician visits occurring later than 21 days after discharge did not further contribute to reducing hospital readmissions. Larger risk reductions were observed among patients in the highest morbidity level and for in-person follow-up with a primary care physician rather than a medical specialist.

conclusionsWhen provided promptly, postdischarge in-person physician visit can prevent many readmissions. The benefits appear optimal when such visit occurs within the first 10 days, or at least within the first 21 days of discharge.

Indexed as

Chronic DiseaseAdultAgedAged, 80 and overAmbulatory CareCanadaFemaleHospitalsHumansInsurance Claim ReviewMaleMiddle AgedPatient DischargePatient ReadmissionPhysicians, Primary CareTime Factorsadministrative data usesambulatory/outpatient careCohort analysis

Identifiers

PMID29766499
PMCPMC6232431
OpenAlexW2804402522

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.