Post-Trauma Follow-up Phone Call Shows Lower Readmission Rates for Patients Discharged From Emergency Department Compared to Inpatient Stay

• Published in: The American surgeon Vol. 87; no. 10; pp. 1633 - 1637
• Main Authors: Hoyos, Juan Pablo, Alaniz, Leonardo, Llerenas, Miguel, Mendoza, Rosemarie, Tay, Erika, Barrios, Cristobal
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.10.2021; SAGE PUBLICATIONS, INC
• Subjects: Adult; Aged; Confidence intervals; Continuity of Patient Care; Demographics; Emergency medical care; Emergency medical services; Female; Health care; Health care facilities; Hispanic people; Hospitals; Humans; Injury analysis; Inpatients - statistics & numerical data; Male; Medicare; Middle Aged; Minority & ethnic groups; Multivariable control; Patient Readmission - statistics & numerical data; Patient satisfaction; Patients; Primary care; Regression analysis; Retrospective Studies; Risk factors; Telephone; Telephone calls; Trauma; Trauma Centers - statistics & numerical data; White people; Wound healing; readmission rates; inpatient; post-trauma; callback; discharged, prescription; follow-up phone call; discharge protocal
• ISSN: 0003-1348; 1555-9823
• DOI: 10.1177/00031348211051694

Background Studies show follow-up phone calls decrease readmission rates (RR) in trauma patients and social vulnerabilities may play a role as well. Minimal literature exists comparing RR of trauma patients who required an inpatient stay to those whose treatment was limited to the Emergency Department (ED), as they are at high risk of recidivism. We hypothesized post-trauma follow-up calls would show higher RR for ED patients than those requiring inpatient stay, as well as potentially differing outcomes for minorities. Study Design A retrospective analysis from 2019-2020 of 1328 trauma patients from UCI Medical Center, discharged from inpatient facilities or the ED. A questionnaire script read by a nurse practitioner to patients via phone call following discharge. Data associated with readmission were captured. Multivariable logistic regression analysis was performed, controlling for patient factors including severity of injury. Results Patients discharged from the ED were 47.4% less likely to be readmitted than those who required an inpatient stay (P < .01). However, ED patients were 88.7% less likely to receive a prescription than inpatient stay patients (P < .01). No difference between ED and inpatient discharge contact rates was noted (P < .99). Furthermore, no difference in readmission rates was noted for minorities. Conclusion Post-trauma follow-up calls showed lower RR for index ED visit patients than those requiring inpatient stay, contrary to expectations. However, ED visit patients were also less likely to receive/fill prescriptions compared to those requiring inpatient stay. Ongoing analysis is warranted to further validate and improve follow-up call programs to ensure equitable health care.