Frequency of new or worsening symptoms in the posthospitalization period

Abstract

BACKGROUND: When patients are discharged from the hospital, they are assumed to be stable until follow-up as outpatients. OBJECTIVE: To study the frequency of new or worsening symptoms within 2-5 days of hospital discharge. DESIGN: Retrospective analysis of data from telephone calls to patients by centralized call center. SETTING: Patients discharged by hospitalists employed by IPC-The Hospitalist Company. PATIENTS: 15,767 patients surveyed between May 1, 2003, and October 31, 2003. INTERVENTION: Patients discharged home were contacted by a central call center in the first several days after discharge. MEASUREMENTS: Patient demographics, self-rated health status, prevalence of new or worsening symptoms, medication issues, home health services issues, and status of scheduled follow-up appointments. RESULTS: Of the patients surveyed, 11.9% reported new or worsening symptoms since leaving the hospital. There were no differences by age. Women were more likely than men to be symptomatic. Patients with worse health status were more likely to have new or worse symptoms (P < .0001). Symptomatic patients were minimally more likely to have made a follow-up appointment (61.0% vs. 58.4%, P < .05) and were more likely to have medication issues (22.2% vs. 6.8%, P < .0001) and problems with receiving home health care services (5.8% vs. 3.6%, P < .05). CONCLUSIONS: A significant percentage of patients had new or worsening symptoms in the first several days after discharge. These patients were only minimally more likely to have made follow-up appointments. A system to manage the postdischarge transition period is essential to improving posthospitalization outcomes.