TY - JOUR
T1 - Effectiveness of Synchronous Postdischarge Contacts on Health Care Use and Patient Satisfaction A Systematic Review and Meta-analysis
AU - Boggan, Joel C.
AU - Sankineni, Spoorthi
AU - Dennis, Paul A.
AU - Chen, Dazhe
AU - Sledge, Tina Wong
AU - Halpern, David
AU - Rushton, Sharron
AU - Williams, John W.
AU - Der, Tatyana
AU - Tabriz, Amir Alishahi
AU - Gordon, Adelaide M.
AU - Jacobs, Morgan
AU - Boucher, Nathan A.
AU - Colandrea, Maria
AU - Alexopoulos, Anastasia Stefania
AU - Jones, Joanne Roman
AU - Leflore-Lloyd, Nina
AU - Cantrell, Sarah
AU - Goldstein, Karen M.
AU - Gierisch, Jennifer M.
N1 - Publisher Copyright:
© 2025 American College of Physicians.
PY - 2025/2
Y1 - 2025/2
N2 - Background: Postdischarge contacts (PDCs) after hospitalization are common practice, but their effectiveness in reducing use of acute care after discharge remains unclear. Purpose: To assess the effects of PDC on 30-day emergency department (ED) visits, 30-day hospital readmissions, and patient satisfaction. Data Sources: MEDLINE, Embase, and CINAHL searched from 2012 to 25 May 2023. Study Selection: Randomized and nonrandomized trials of PDC within 7 days. Data Extraction: Two investigators independently screened articles and assessed risk of bias (ROB). Single reviewers extracted data, with verification by second investigators. Random-effects meta-analyses were done on outcomes shared by at least 3 studies, and the certainty of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework. Data Synthesis: Of 13 included studies (11 randomized trials [RTs]), 12 delivered PDCs via telephone. Three of 11 RTs were rated as having low ROB, with 1 rated high. Most PDC interventions (n = 10) consisted of single telephone contacts, often within 3 days. Eight studies focused on patients identified as higher-risk by the authors. There were no differences in 30-day ED use (5 RTs; 3054 patients; risk difference, 0.00 [95% CI, -0.02 to 0.03]; moderate certainty) or 30-day hospital readmissions (7 RTs; 7075 patients; risk difference, 0.00 [CI, -0.02 to 0.02]; moderate certainty) with PDC. Limitation: Adherence and fidelity to PDC interventions were poorly described, and only 1 study investigated nontelephone PDC. Conclusion: Postdischarge contacts within 7 days of discharge were not associated with reductions in 30-day ED use or readmissions compared with usual care. Health systems should reconsider the utility of universal PDCs because multifaceted interventions targeting higher-risk patients may be necessary to reduce use of acute care after discharge.
AB - Background: Postdischarge contacts (PDCs) after hospitalization are common practice, but their effectiveness in reducing use of acute care after discharge remains unclear. Purpose: To assess the effects of PDC on 30-day emergency department (ED) visits, 30-day hospital readmissions, and patient satisfaction. Data Sources: MEDLINE, Embase, and CINAHL searched from 2012 to 25 May 2023. Study Selection: Randomized and nonrandomized trials of PDC within 7 days. Data Extraction: Two investigators independently screened articles and assessed risk of bias (ROB). Single reviewers extracted data, with verification by second investigators. Random-effects meta-analyses were done on outcomes shared by at least 3 studies, and the certainty of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework. Data Synthesis: Of 13 included studies (11 randomized trials [RTs]), 12 delivered PDCs via telephone. Three of 11 RTs were rated as having low ROB, with 1 rated high. Most PDC interventions (n = 10) consisted of single telephone contacts, often within 3 days. Eight studies focused on patients identified as higher-risk by the authors. There were no differences in 30-day ED use (5 RTs; 3054 patients; risk difference, 0.00 [95% CI, -0.02 to 0.03]; moderate certainty) or 30-day hospital readmissions (7 RTs; 7075 patients; risk difference, 0.00 [CI, -0.02 to 0.02]; moderate certainty) with PDC. Limitation: Adherence and fidelity to PDC interventions were poorly described, and only 1 study investigated nontelephone PDC. Conclusion: Postdischarge contacts within 7 days of discharge were not associated with reductions in 30-day ED use or readmissions compared with usual care. Health systems should reconsider the utility of universal PDCs because multifaceted interventions targeting higher-risk patients may be necessary to reduce use of acute care after discharge.
UR - https://www.scopus.com/pages/publications/85218077122
UR - https://www.scopus.com/pages/publications/85218077122#tab=citedBy
U2 - 10.7326/ANNALS-24-01140
DO - 10.7326/ANNALS-24-01140
M3 - Article
C2 - 39805113
AN - SCOPUS:85218077122
SN - 0003-4819
VL - 178
SP - 229
EP - 240
JO - Annals of Internal Medicine
JF - Annals of Internal Medicine
IS - 2
ER -