Post-Discharge Transitional Care Program and Patient Compliance With Follow-Up Activities

Area of Science:

• Health Services Research
• Patient Care Management
• Clinical Outcomes

Background:

• Effective post-hospital discharge transitional care is crucial for patient adherence to treatment plans.
• The optimal frequency of transitional care calls remains an area for investigation.

Purpose of the Study:

• To investigate the association between the frequency of transitional care calls and patient adherence to discharge plans.
• To determine the impact of call frequency on appointment scheduling, procedure completion, and adverse event reporting.

Main Methods:

• Analysis of 1,000 call records from a tertiary care hospital's transitional care program (2018-2019).
• Utilized linear probability models (LPM) to assess the relationship between call completion success and patient outcomes.
• Controlled for sociodemographic and clinical characteristics in the analysis.

Main Results:

• Successful completion of the first two calls significantly increased the probability of scheduling/completing follow-up appointments (15.5% points) and procedures (13.5% points).
• Increased call frequency was also associated with a higher probability of reporting new adverse clinical events (5.9% points).
• While the first call is important, two to three calls appear more optimal for patient adherence.

Conclusions:

• Transitional care programs should aim for two to three post-discharge calls to maximize patient adherence and clinical event reporting.
• A single call may be insufficient for effective care transitions; further calls beyond three may offer diminishing returns.