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Lack of PCP follow up means longer length of stay and readmissions

Hospitalist Leadership Connection, October 12, 2010

The time between the inpatient and outpatient setting is usually a high-risk period for patients. A new study from the University of Colorado Denver found that, after patient discharge, lack of primary care physician (PCP) follow up led to higher rates of hospital readmission and longer length of stays, according to “Post-Hospitalization Transitions: Examining the Effects of Timing of Primary Care Provider Follow-Up,” published in the September Journal of Hospital Medicine.

Researchers surveyed 65 patients who completed phone interviews four weeks after their initial discharge. They found that almost half the time (49.5%), PCPs followed up with their patients. Those patients that didn’t receive follow up tended to be younger and uninsured and lacked a regular PCP.

Researchers found that patients lacking timely PCP follow up were 10 times more likely to be readmitted; hospital readmission rates were significantly higher in patients who didn’t have PCP follow up (21.2%) than those that did (3.1%) with the same medical condition. Patients who didn’t have PCP follow up also stayed in the hospital longer (6.3 days) compared to those that did have follow up (4.4 days).

“. . .[C]are coordination by advanced nurse practitioners, follow-up pharmacist phone calls, and involvement of a transition coach encouraging active patient involvement—all are known to improve patient outcomes following hospitalization,” states the study. “The active involvement of a PCP is central to a number of these proven interventions to ensure effective completion of ongoing patient care.”

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