Physician visits after hospital discharge

Abstract

Public and private payers view reducing avoidable hospital readmissions as a way to improve quality and reduce unnecessary costs. While policy makers have targeted readmissions stemming from poor quality of care during an initial hospital stay, readmissions also can occur when patients don’t receive appropriate follow-up care or ongoing outpatient management of other conditions. One in three adult patients—aged 21 and older—discharged from a hospital to the community does not see a physician within 30 days of discharge, according to a new national study by the Center for Studying Health System Change (HSC). Many people who do not see a physician are at high risk of readmission because of chronic conditions or physical activity limitations. The study findings indicate that gaps in care after discharge are common for adults covered by all types of insurance. The lack of a usual source of care does not appear to be a barrier to receiving follow-up care, but many patients discharged from a hospital to home face challenges accessing their usual source of care. The implication is that reforms specific to one payer and focusing only on care processes within hospitals may fall short unless efforts to coordinate with community providers—and to encourage patients’ access to these providers—receive at least as much attention. Strategies that could address gaps in care after discharge include bundled payments and patient-centered medical home efforts, which have potential to encourage hospitals and community-based clinicians to work together to lower rates of avoidable readmissions or rehospitalizations for other conditions. Moreover, investments in well-designed health information technology could help physician practices identify and monitor care for high-risk patients and foster information sharing between hospitals and community-based physicians.