Associations Between Early Physician Follow-up and Post-discharge Outcomes: A Systematic Review and Meta-analysis

Area of Science:

• Health Services Research
• Clinical Outcomes
• Evidence Synthesis

Background:

• Early physician follow-up post-hospitalization is recommended but its impact on adverse events is debated.
• Systematic review and meta-analysis to assess the association between early physician follow-up and patient outcomes.

Purpose of the Study:

• To examine the association between physician follow-up within 30 days of hospital discharge and the risk of hospital readmission, emergency department visits, or mortality in medical patients.

Main Methods:

• Systematic search of MEDLINE, EMBASE, and CINAHL databases up to April 2023.
• Inclusion of original studies on adult medical patients reporting on early physician follow-up and adverse events.
• Meta-analyses using random effects models to pool data from 66 included studies.

Main Results:

• Early physician follow-up was associated with reduced odds of hospital readmission (OR 0.69) and mortality (OR 0.71).
• No significant association was found for emergency department visits (OR 0.77).
• Bias in majority of studies and lack of statistical significance in low-bias/RCT subgroups question these findings.

Conclusions:

• Meta-analysis suggests potential benefits of early physician follow-up for reducing readmissions and mortality.
• High risk of bias and observational nature of most studies necessitate cautious interpretation.
• The effectiveness of early physician follow-up in reducing post-discharge adverse events remains unclear.