Effect of Outpatient Visits and Discharge Destination on Potentially Preventable Readmissions for Congestive Heart Failure and Bacterial Pneumonia


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.

Upper Midwest Rural Health Research Center
Marilyn Klug, Kyle Muus