Association of a Post-Discharge Phone Call With Post-Acute Care Utilization During the COVID-19 Pandemic

A care-coordination telephone call made to a patient after home discharge has been associated with reduced 30-day readmissions. It is unclear whether this relationship persisted during the pandemic, when readmission rates were higher and fewer wrap-around services existed. Further, there is rising concern that readmission is an inadequate surrogate for post-acute care utilization. Our study aims to determine the association of a post-discharge phone call with three 30-day utilization outcomes during the pandemic: readmission rates, ED visits, and observation status.

We conducted a retrospective analysis of 3555 patients discharged home from medicine services at 3 hospitals between December 2020 and July 2022. Patients discharged home without additional skilled services qualified for a phone call. We tracked readmissions, ED visits, and observation stays within 30 days of each initial hospital admission. Using logistic regression, we analyzed whether call receipt was associated with these outcomes.

When adjusted for patient and system covariates, the post-discharge phone call was associated with a significant reduction in 30-day observation stays (OR 0.60; CI 0.45-0.80, P < .001). It was not associated with a significant reduction in 30-day ED visits (OR 1.02; CI 0.85-1.23, P = .08) or 30-day readmission rates (OR 0.95; CI 0.72-1.26, P = .72).

During the pandemic, the post-discharge phone call was not associated with a reduction in 30-day readmissions or ED visits. It was, however, associated with a significant reduction in observation stays, a finding that warrants further investigation.