Effectiveness of Postdischarge Telephone Calls in Reducing Hospital Utilization: Quasi-Randomized Controlled Trial

Area of Science:

• Healthcare Management
• Digital Health
• Patient Care

Background:

• Unplanned emergency department (ED) visits and hospital readmissions increase healthcare costs and negatively impact patient well-being.
• Early post-discharge follow-up is crucial for improving care transitions, but the effectiveness of telephone interventions remains debated.
• Telephone calls offer an accessible, low-barrier digital health solution, potentially improving equity for patients facing barriers to in-person or high-technology care.

Purpose of the Study:

• To evaluate the impact of a nurse-led postdischarge telephone intervention on short-term ED visits and hospital readmissions in high-risk patients.
• To assess patient experiences with the telephone follow-up service.
• To identify care gaps addressed during postdischarge calls.

Main Methods:

• A pragmatic quasi-randomized trial involving 7091 high-risk patients (LACE index ≥10 or <9 and ≥45 years) was conducted.
• Participants were allocated to a nurse-led telephone intervention (48 hours post-discharge) or standard care.
• Primary outcomes included ED visits at 7 and 30 days; secondary outcomes were hospital readmissions and patient experience, analyzed using negative binomial regression.

Main Results:

• The intervention group showed a significant reduction in ED visits at 7 days (IRR 0.719) and 30 days (IRR 0.878).
• No statistically significant reductions in hospital readmissions were observed at 7 or 30 days.
• Forty percent of completed calls identified care gaps, and most participants found the calls helpful, increasing their confidence in self-care.

Conclusions:

• Structured nurse-led postdischarge telephone calls effectively reduce short-term ED utilization among high-risk patients.
• The intervention demonstrates the potential of telephone-based virtual care as a scalable strategy to improve care transitions and decrease avoidable ED visits.
• Additional interventions may be necessary to address and reduce hospital readmission rates in this population.