Category: Health Policy and Systems
Discharge from an inpatient hospitalization is a high-risk moment in a patient’s hospital course, with discharge paperwork providing guidance for transition of care to outpatient providers. Previous studies have found that patients with appointments scheduled prior to discharge had lower odds of hospital re-admitted. Discharge from an acute inpatient rehabilitation presents additional challenges due to being culmination of not one, but often two subsequent hospital courses. The goal was to identify which types of needed medical appointments were unscheduled at time of discharge.
Retrospective study prior to data collection. Indicated discharge appointments were identified from 212 subjects from January to June 2019 then coded for scheduled/unscheduled and by medical specialty.
From the total 721 indicated appointments, documentation of needed primary care physician (PCP) and physiatry (PM&R) follow-up were missed far more often than other specialty appointments at 68% and 26% respectively compared to 7% for all other specialties combined. Excluding PM&R and PCP, Fisher’s exact comparing unscheduled appointments to those of other medical specialties was significant only for neurology (p = 0.01).
In our single site study, discharge documentation of needed PM&R, PCP, and neurology follow-up were less consistently scheduled. Further investigation should be performed to elucidate etiology and potential interventions to reduce unscheduled appointments with additional focus on these three medical areas.
William Carter– Assistant Professor, Virginia Commonwealth University
Rajbir Chaggar– Resident Physician, Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University Health System
Kevin Forster– Resident Physician, VCU Health
Graham McRary– Resident Physician, Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University Health System
Brian Dena– Resident Physician, VCU Health System