Postdischarge phone follow-ups have no benefit on elderly patients’ return to ED

Telephone follow-ups after discharge from the emergency department (ED) have no clear impact on hospital return rates among elderly patients, a recent study has found.

Researchers performed a pragmatic randomized controlled trial including 3,175 community dwelling older adults, assigned to either the intervention (n=1,516) or the control (n=1,659) group. Both groups were followed-up by phone after ED discharge; the former was interviewed to identify postdischarge problems, while the latter was surveyed for satisfaction with their ED visit. The primary outcome was unplanned hospital admissions and ED returns 30 days after discharge.

Unplanned hospital admissions or ED return visits occurred in 16 percent of the intervention group and 14 percent of the control group. The telephone follow-up intervention had no significant impact on the primary outcome (odds ratio [OR], 1.16, 95 percent confidence interval [CI], 0.96–1.42).

This null association was generally true throughout different patient subgroups. The phone intervention had no effect on the primary outcome in men (OR, 1.20, 95 percent CI, 0.90–1.60) or women (OR, 1.13, 95 percent CI, 0.0.86–1.48) or in those living alone (OR, 1.10, 95 percent CI, 0.79–1.52) or with other people (OR, 1.08, 95 percent CI, 0.81–1.43).

Notably, phone follow-ups for postdischarge complications even increased the risk of unplanned return visits among participants <78 years of age (OR, 1.33, 95 percent CI, 1.01–1.75).

“This study did not find a beneficial effect of a telephone follow-up call on reducing unplanned hospital admissions and/or ED return visits,” the researchers said. “Based on the results of this large study … we advise not to introduce telephone follow-up to reduce unplanned hospital admissions and ED return visits in older patients.

“Future studies could evaluate the effects of this intervention on other health-related outcomes,” they added.