Explores the relationship between potentially preventable
readmissions (PPRs) and (a) use of outpatient follow-up
care, (b) discharge destination, (c) rural versus urban
residence of the patient, and (d) time to follow-up care.
These factors were examined in a large population of
Medicare patients with a hospital stay for one of these
prevalent diagnoses: congestive heart failure or
bacterial pneumonia. Differences in readmission risk
associated with outpatient visits and discharge
destinations were calculated. Outpatient follow-up
appears to be strongly influential in reducing PPRs,
though fewer than half of the patients in the study had
evidence of any kind of outpatient follow-up within 30
days. Home health care appeared to have less of an effect
on reducing PPRs in rural areas relative to urban areas.
Swing bed destination was associated with higher PPR
risk, especially for pneumonia patients. Additional
research should be done on encouragement of
post-discharge follow-up care and types of outpatient
interventions, access to outpatient and home health care,
and use of swing beds in rural areas.