Frequency of new or worsening symptoms in the posthospitalization period.
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.


METHODS
Retrospective analysis of data from telephone calls to patients by centralized call center.


METHODS
Patients discharged by hospitalists employed by IPC-The Hospitalist Company.


METHODS
15,767 patients surveyed between May 1, 2003, and October 31, 2003.


METHODS
Patients discharged home were contacted by a central call center in the first several days after discharge.


METHODS
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.
Epstein
Kenneth
K
IPC-The Hospitalist Company, North Hollywood, California, USA. kepstein@ipcm.com
Juarez
Esther
E
Loya
Kathy
K
Gorman
Mary Jo
MJ
Singer
Adam
A
D000359:Aftercare / Q000379:methods / Q000592:standards; D016009:Chi-Square Distribution; D005260:Female; D006305:Health Status Indicators; D020445:Hospitalists; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011787:Quality of Health Care; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013689:Telephone