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

Area of Science:

• Healthcare Management
• Patient Outcomes
• Public Health

Background:

• Post-discharge care coordination calls were previously linked to reduced hospital readmissions.
• The impact of these calls during the COVID-19 pandemic, with higher readmission rates and fewer support services, remained unclear.
• Readmission rates may not fully capture post-acute care utilization.

Purpose of the Study:

• To investigate the association between post-discharge phone calls and 30-day utilization outcomes during the pandemic.
• To examine the impact on readmission rates, emergency department (ED) visits, and observation stays.
• To assess the effectiveness of a simple care coordination intervention amidst evolving healthcare challenges.

Main Methods:

• Retrospective analysis of 3555 patients discharged from medicine services across three hospitals (December 2020 - July 2022).
• Inclusion criteria: patients discharged home without additional skilled services were eligible for a post-discharge phone call.
• Logistic regression analysis was used to determine the association between call receipt and 30-day utilization outcomes (readmissions, ED visits, observation stays).

Main Results:

• A post-discharge phone call was significantly associated with a reduction in 30-day observation stays (OR 0.60; 95% CI 0.45-0.80).
• No significant association was found between the calls and reduced 30-day ED visits (OR 1.02; 95% CI 0.85-1.23).
• The calls were also not associated with a significant reduction in 30-day readmission rates (OR 0.95; 95% CI 0.72-1.26).

Conclusions:

• During the pandemic, post-discharge phone calls did not reduce 30-day readmissions or ED visits.
• A significant reduction in 30-day observation stays was observed, suggesting a potential benefit for this specific utilization metric.
• The findings highlight the need for further investigation into the role of post-discharge calls in managing post-acute care utilization, particularly observation stays.