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A comparison of hospital readmission rates between two general physicians with different outpatient review practices

BACKGROUND: There has been a relentless increase in emergency medical admissions in the UK over recent years. Many of these patients suffer with chronic conditions requiring continuing medical attention. We wished to determine whether conventional outpatient clinic follow up after discharge has any...

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Autores principales: Rayner, Hugh C, Mark Temple, R, Marshall, Tim, Clarke, Dianne
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2002
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC117439/
https://www.ncbi.nlm.nih.gov/pubmed/12084180
http://dx.doi.org/10.1186/1472-6963-2-12
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author Rayner, Hugh C
Mark Temple, R
Marshall, Tim
Clarke, Dianne
author_facet Rayner, Hugh C
Mark Temple, R
Marshall, Tim
Clarke, Dianne
author_sort Rayner, Hugh C
collection PubMed
description BACKGROUND: There has been a relentless increase in emergency medical admissions in the UK over recent years. Many of these patients suffer with chronic conditions requiring continuing medical attention. We wished to determine whether conventional outpatient clinic follow up after discharge has any impact on the rate of readmission to hospital. METHODS: Two consultant general physicians with the same patient case-mix but markedly different outpatient follow-up practice were chosen. Of 1203 patients discharged, one consultant saw twice as many patients in the follow-up clinic than the other (Dr A 9.8% v Dr B 19.6%). The readmission rate in the twelve months following discharge was compared in a retrospective analysis of hospital activity data. Due to the specialisation of the admitting system, patients mainly had cardiovascular or cerebrovascular disease or had taken an overdose. Few had respiratory or infectious diseases. Outpatient follow-up was focussed on patients with cardiac disease. RESULTS: Risk of readmission increased significantly with age and length of stay of the original episode and was less for digestive system and musculo-skeletal disorders. 28.7% of patients discharged by Dr A and 31.5 % of those discharged by Dr B were readmitted at least once. Relative readmission risk was not significantly different between the consultants and there was no difference in the length of stay of readmissions. CONCLUSIONS: Increasing the proportion of patients with this age- and case-mix who are followed up in a hospital general medical outpatient clinic is unlikely to reduce the demand for acute hospital beds.
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spelling pubmed-1174392002-07-26 A comparison of hospital readmission rates between two general physicians with different outpatient review practices Rayner, Hugh C Mark Temple, R Marshall, Tim Clarke, Dianne BMC Health Serv Res Research Article BACKGROUND: There has been a relentless increase in emergency medical admissions in the UK over recent years. Many of these patients suffer with chronic conditions requiring continuing medical attention. We wished to determine whether conventional outpatient clinic follow up after discharge has any impact on the rate of readmission to hospital. METHODS: Two consultant general physicians with the same patient case-mix but markedly different outpatient follow-up practice were chosen. Of 1203 patients discharged, one consultant saw twice as many patients in the follow-up clinic than the other (Dr A 9.8% v Dr B 19.6%). The readmission rate in the twelve months following discharge was compared in a retrospective analysis of hospital activity data. Due to the specialisation of the admitting system, patients mainly had cardiovascular or cerebrovascular disease or had taken an overdose. Few had respiratory or infectious diseases. Outpatient follow-up was focussed on patients with cardiac disease. RESULTS: Risk of readmission increased significantly with age and length of stay of the original episode and was less for digestive system and musculo-skeletal disorders. 28.7% of patients discharged by Dr A and 31.5 % of those discharged by Dr B were readmitted at least once. Relative readmission risk was not significantly different between the consultants and there was no difference in the length of stay of readmissions. CONCLUSIONS: Increasing the proportion of patients with this age- and case-mix who are followed up in a hospital general medical outpatient clinic is unlikely to reduce the demand for acute hospital beds. BioMed Central 2002-06-25 /pmc/articles/PMC117439/ /pubmed/12084180 http://dx.doi.org/10.1186/1472-6963-2-12 Text en Copyright © 2002 Rayner et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.
spellingShingle Research Article
Rayner, Hugh C
Mark Temple, R
Marshall, Tim
Clarke, Dianne
A comparison of hospital readmission rates between two general physicians with different outpatient review practices
title A comparison of hospital readmission rates between two general physicians with different outpatient review practices
title_full A comparison of hospital readmission rates between two general physicians with different outpatient review practices
title_fullStr A comparison of hospital readmission rates between two general physicians with different outpatient review practices
title_full_unstemmed A comparison of hospital readmission rates between two general physicians with different outpatient review practices
title_short A comparison of hospital readmission rates between two general physicians with different outpatient review practices
title_sort comparison of hospital readmission rates between two general physicians with different outpatient review practices
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC117439/
https://www.ncbi.nlm.nih.gov/pubmed/12084180
http://dx.doi.org/10.1186/1472-6963-2-12
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