Evidence map›Paper›PMID 37697250›Full record

ArticleBMC geriatrics2023

Recent functional decline and outpatient follow-up after hospital discharge: a cohort study.

Orly Bogler, David Kirkwood, Peter C Austin, Aaron Jones, Chi-Ling Joanna Sinn, Karen Okrainec, Andrew Costa, Lauren Lapointe-Shaw

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC geriatrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.7field-weighted citation impact, top 30% 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

4 citing papers in PubMed, 4 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. 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

8 authors at 3 institutions in 1 country.

Orly BoglerFaculty of Medicine, University of Toronto, Toronto, Canada. orly.bogler@mail.utoronto.ca.
David KirkwoodInstitute for Clinical Evaluative Sciences McMaster, Hamilton, Canada.
Peter C AustinInstitute for Clinical Evaluative Sciences, Toronto, Canada.
Aaron JonesInstitute for Clinical Evaluative Sciences McMaster, Hamilton, Canada.
Chi-Ling Joanna SinnDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.
Karen OkrainecInstitute for Clinical Evaluative Sciences, Toronto, Canada.
Andrew CostaInstitute for Clinical Evaluative Sciences McMaster, Hamilton, Canada.
Lauren Lapointe-ShawInstitute for Clinical Evaluative Sciences, Toronto, Canada.
Institute for Clinical Evaluative Sciences · CAUniversity of Toronto · CAMcMaster University · CA

Funding

CIHR 148933
6 · The paper itself

Abstract

backgroundFunctional decline is common following acute hospitalization and is associated with hospital readmission, institutionalization, and mortality. People with functional decline may have difficulty accessing post-discharge medical care, even though early physician follow-up has the potential to prevent poor outcomes and is integral to high-quality transitional care. We sought to determine whether recent functional decline was associated with lower rates of post-discharge physician follow-up, and whether this association changed during the COVID-19 pandemic, given that both functional decline and COVID-19 may affect access to post-discharge care.

methodWe conducted a retrospective cohort study using health administrative data from Ontario, Canada. We included patients over 65 who were discharged from an acute care facility during March 1st, 2019 - January 31st, 2020 (pre-COVID-19 period), and March 1st, 2020 - January 31st, 2021 (COVID-19 period), and who were assessed for home care while in hospital. Patients with and without functional decline were compared. Our primary outcome was any physician follow-up visit within 7 days of discharge. We used propensity score weighting to compare outcomes between those with and without functional decline.

resultsOur study included 21,771 (pre-COVID) and 17,248 (COVID) hospitalized patients, of whom 15,637 (71.8%) and 12,965 (75.2%) had recent functional decline. Pre-COVID, there was no difference in physician follow-up within 7 days of discharge (Functional decline 45.0% vs. No functional decline 44.0%; RR = 1.02, 95% CI 0.98-1.06). These results did not change in the COVID-19 period (Functional decline 51.1% vs. No functional decline 49.4%; RR = 1.03, 95% CI 0.99-1.08, Z-test for interaction p = 0.72). In the COVID-19 cohort, functional decline was associated with having a 7-day physician virtual visit (RR 1.15; 95% CI 1.08-1.24) and a 7-day physician home visit (RR 1.64; 95% CI 1.10-2.43).

conclusionsFunctional decline was not associated with reduced 7-day post-discharge physician follow-up in either the pre-COVID-19 or COVID-19 periods. In the COVID-19 period, functional decline was positively associated with 7-day virtual and home-visit follow-up.

Indexed as

COVID-19OutpatientsAftercareCohort StudiesFollow-Up StudiesHospitalsHumansOntarioPandemicsPatient DischargeRetrospective StudiesFunctional declineHealth servicesHomecareHospital dischargePhysician follow-upReadmissions

Identifiers

PMID37697250
PMCPMC10496187
OpenAlexW4386602462

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.