Timely Outpatient Follow-up Is Associated with Fewer Hospital Readmissions among Patients with Behavioral Health Conditions

Abstract

Background: Hospital readmissions contribute to high health care costs and are an indicator of poor performance. Reducing readmissions through reconnecting patients to primary care after hospitalization is a solution that is particularly relevant to complex patients with behavioral health conditions. We therefore aimed to examine the rate of follow-up visits among patients with behavioral health conditions and to assess the impact of this visit on the subsequent rate of readmission. Methods: In this retrospective, observational study, we analyzed data from low-income uninsured adults with behavioral health conditions (n = 1905) enrolled in a health care coverage program implemented by a California County from 2012 to 2013. We used administrative encounter and eligibility data and 2 logistic regression models to predict the (1) likelihood of a timely follow-up outpatient visit and (2) likelihood of a readmission given a timely outpatient visit. Our outcomes were to calculate the marginal effects of an outpatient visit within 15 days and a readmission within 30 days of the index admission. Results: The 15-day follow-up visit rate was 42% and readmission rate was 13%. Higher severity of illness (2.5%; P = .004; 95% CI, 0.01–0.04) and prior visits to providers (5.8%; P = .000; 95% CI, 0.04–0.08) increased the probability of a follow-up visit within 15 days. Follow-up visits (−2.5%; P = .021; 95% CI, −0.05-0.00) and a shorter index admission (0.5%; P = .039; 95% CI, 0.00–0.01) also reduced the risk of 30-day readmissions. Conclusion: The findings provide evidence that timely linking of behavioral health patients to outpatient care after hospitalization is an effective care transition strategy, as it is likely to reduce readmission rates.