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Table 3 Weighted models examining the effect of post-hospital follow-up provider visits completed within 7-days of discharge on all cause 30-day inpatient and observation stay readmission stratified by age, service line, and readmission risk

From: Association between post-hospital clinic and telephone follow-up provider visits with 30-day readmission risk in an integrated health system

 

All patients

Age: 65+

Age < 65

n = 213,513

n = 102,011

n = 111,502

Crude

HR (95%CI)

Weighted

HR (95%CI)

Crude

HR (95%CI)

Weighted

HR (95%CI)

Crude

HR (95%CI)

Weighted

HR (95%CI)

All Patients

 POSH vs. no visit

1.34 (1.3, 1.38)

0.83 (0.77, 0.9)

1.17 (1.12, 1.22)

0.83 (0.76, 0.92)

1.38 (1.31, 1.46)

0.82 (0.71, 0.95)

 TPOSH vs. no visit

1.85 (1.74, 1.95)

0.97 (0.9, 1.05)

1.51 (1.41, 1.62)

0.94 (0.86, 1.03)

2.10 (1.9, 2.32)

1.04 (0.92, 1.19)

 nonPOSH vs. no visit

1.37 (1.33, 1.41)

1.05 (0.98, 1.13)

1.15 (1.11, 1.2)

1.08 (1.00, 1.18)

1.59 (1.53, 1.66)

0.98 (0.86, 1.12)

 POSH vs. TPOSH

0.73 (0.68, 0.77)

0.85 (0.79, 0.93)

0.77 (0.72, 0.83)

0.89 (0.8, 0.98)

0.66 (0.59, 0.73)

0.79 (0.68, 0.91)

Medicine, n = 112,668

 POSH vs. no visit

0.91 (0.88, 0.95)

0.79 (0.73, 0.86)

0.85 (0.81, 0.89)

0.81 (0.73, 0.89)

0.95 (0.89, 1.01)

0.75 (0.65, 0.88)

 TPOSH vs. no visit

1.31 (1.23, 1.39)

0.95 (0.87, 1.02)

1.13 (1.05, 1.22)

0.93 (0.85, 1.02)

1.54 (1.38, 1.73)

0.98 (0.85, 1.13)

 nonPOSH vs. no visit

1.14 (1.09, 1.18)

1.04 (0.96, 1.12)

1.11 (1.05, 1.17)

1.07 (0.98, 1.17)

1.19 (1.12, 1.26)

0.95 (0.82, 1.09)

 POSH vs. TPOSH

0.7 (0.65, 0.74)

0.84 (0.77, 0.91)

0.75 (0.69, 0.80)

0.87 (0.78, 0.96)

0.61 (0.55, 0.69)

0.77 (0.65, 0.9)

LACE 11+ (High risk)

 POSH vs. no visit

0.73 (0.69, 0.76)

0.77 (0.71, 0.85)

0.75 (0.71, 0.80)

0.79 (0.71, 0.88)

0.67 (0.62, 0.74)

0.72 (0.61, 0.86)

 TPOSH vs. no visit

0.92 (0.86, 0.99)

0.91 (0.83, 0.99)

0.94 (0.87, 1.03)

0.92 (0.83, 1.02)

0.87 (0.76, 1.00)

0.87 (0.74, 1.03)

 nonPOSH vs. no visit

0.99 (0.94, 1.04)

1.01 (0.93, 1.09)

1.04 (0.97, 1.11)

1.05 (0.96, 1.16)

0.89 (0.81, 0.97)

0.90 (0.77, 1.05)

 POSH vs. TPOSH

0.79 (0.74, 0.85)

0.85 (0.77, 0.94)

0.80 (0.74, 0.87)

0.86 (0.77, 0.97)

0.78 (0.68, 0.89)

0.82 (0.69, 0.99)

LACE < 11 (Medium/low risk)

 POSH vs. no visit

0.87 (0.82, 0.93)

0.84 (0.67, 1.05)

0.83 (0.76, 0.91)

0.86 (0.65, 1.15)

0.86 (0.78, 0.95)

0.79 (0.55, 1.13)

 TPOSH vs. no visit

1.23 (1.06, 1.43)

1.14 (0.94, 1.39)

1.01 (0.83, 1.24)

1.02 (0.78, 1.33)

1.44 (1.15, 1.80)

1.32 (0.98, 1.78)

 nonPOSH vs. no visit

1.21 (1.14, 1.29)

1.16 (0.96, 1.42)

1.16 (1.06, 1.27)

1.19 (0.92, 1.54)

1.27 (1.17, 1.39)

1.15 (0.85, 1.56)

 POSH vs. TPOSH

0.71 (0.61, 0.82)

0.73 (0.58, 0.92)

0.82 (0.67, 1.01)

0.85 (0.63, 1.14)

0.59 (0.47, 0.75)

0.60 (0.42, 0.85)

All Surgical n = 100,845

 POSH vs. no visit

1.35 (1.24, 1.46)

1.01 (0.8, 1.28)

1.21 (1.08, 1.35)

0.93 (0.69, 1.25)

1.34 (1.19, 1.51)

1.11 (0.76, 1.63)

 TPOSH vs. no visit

1.68 (1.43, 1.96)

1.17 (0.94, 1.45)

1.48 (1.20, 1.83)

1.05 (0.79, 1.39)

1.68 (1.31, 2.15)

1.34 (0.94, 1.89)

 nonPOSH vs. no visit

1.65 (1.57, 1.73)

1.07 (0.86, 1.34)

1.17 (1.08, 1.27)

1.01 (0.76, 1.36)

1.93 (1.82, 2.05)

1.18 (0.83, 1.67)

 POSH vs. TPOSH

0.81 (0.68, 0.96)

0.87 (0.68, 1.10)

0.82 (0.65, 1.02)

0.89 (0.66, 1.20)

0.80 (0.61, 1.05)

0.83 (0.57, 1.21)

LACE 11+ (High risk)

 POSH vs. no visit

0.73 (0.64, 0.84)

0.77 (0.56, 1.07)

0.75 (0.63, 0.89)

0.80 (0.54, 1.16)

0.72 (0.58, 0.89)

0.72 (0.39, 1.32)

 TPOSH vs. no visit

1.11 (0.88, 1.38)

1.1 (0.82, 1.47)

1.12 (0.84, 1.48)

1.05 (0.74, 1.49)

1.11 (0.76, 1.62)

1.20 (0.71, 2.03)

 nonPOSH vs. no visit

0.95 (0.84, 1.06)

0.95 (0.7, 1.29)

0.93 (0.8, 1.09)

0.97 (0.67, 1.41)

0.95 (0.80, 1.13)

0.90 (0.52, 1.55)

 POSH vs. TPOSH

0.66 (0.53, 0.84)

0.7 (0.51, 0.97)

0.67 (0.50, 0.90)

0.76 (0.51, 1.12)

0.64 (0.44, 0.95)

0.60 (0.33, 1.07)

LACE < 11 (Medium/low risk)

 POSH vs. no visit

1.21 (1.08, 1.36)

1.36 (0.96, 1.92)

1.21 (1.02, 1.43)

1.24 (0.76, 2.03)

1.14 (0.97, 1.34)

1.43 (0.87, 2.37)

 TPOSH vs. no visit

1.3 (1.03, 1.65)

1.28 (0.91, 1.80)

1.22 (0.88, 1.70)

1.17 (0.72, 1.88)

1.27 (0.9, 1.80)

1.37 (0.84, 2.22)

 nonPOSH vs. no visit

1.75 (1.66, 1.85)

1.30 (0.92, 1.82)

1.20 (1.09, 1.33)

1.17 (0.72, 1.92)

2.02 (1.9, 2.15)

1.42 (0.89, 2.27)

 POSH vs. TPOSH

0.93 (0.72, 1.21)

1.06 (0.75, 1.49)

0.99 (0.69, 1.41)

1.07 (0.67, 1.70)

0.90 (0.62, 1.31)

1.05 (0.64, 1.73)

  1. Values are presented as hazard ratio (HR) and 95% confidence intervals
  2. POSH Post-hospital follow-up clinic visit, TPOSH Telephone post-hospital follow-up visit, nonPOSH Visit not related to post-hospital follow-up, LACE Length of stay; Acuity of admission; Co-morbidities; Emergency visits in previous 6 months
  3. Matching weights were used, based on multinomial propensity score models that included age, gender, race/ethnicity, being partnered, no-show history in the last 12 months, receipt of medical financial assistance in the year prior to admission (a marker of social risk), frailty category, risk for readmission or early death (LACE category), severity of hospitalization (LAPS2), service line (medicine vs. surgical), functional status (non-ambulatory, ambulatory with assistance, or ambulatory) and fall risk (Schmid score of 3+) within 24 h of discharge; disposition (home vs. home health), and hospital site