Hospital readmissions are important as they are costly, are associated with high mortality, morbidity and an increased risk of long-term care, and are important as readmissions are now included in Pay-for-Performance (P4P) programs (1-3). One potential mechanism to reduce readmission is through outpatient follow-up visits with a physician after initial discharge (4). This review seeks to understand the effect outpatient follow-up visits have on all-cause 30-day readmissions for patients with an initial discharge of Acute Myocardial Infarction (AMI), heart failure, Chronic Obstructive Pulmonary Disease (COPD) or an acute stroke event. We conducted a systematic review and meta-analysis of observational studies, searching the PubMed and CINAHL databases. The search consisted of articles published in the United States over a 10 year period 2007 through 2017. We calculated relative risk (RR) and 95% confidence intervals for each outcome and assessed heterogeneity using the I2 and Q-statistics. From 573 hits, we identified 10 eligible studies. The pooled RR from the six patient-level studies found that outpatient follow-up visits reduced the risk of readmission by 13% (RR= 0.87; 95% CI 0.77-0.97, p= 0.014). However, the I2 statistic was 65.5% and the Q-statistic p-value was 0.05, indicating that there is a moderate to substantial amount of heterogeneity. Hospital-level studies were not included in the analysis. Although some evidence exists for the benefit of outpatient follow-up visits with a physician, additional evidence is needed in order to quantify the impact of outpatient follow-up visits to reduce 30-day readmissions. -- Abstract.
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