Timely access to primary care followup is an important factor in preventing hospital readmissions. Patients that lack primary care followup within four weeks of discharge are more likely to be readmitted. Moreover, resident clinics are often understaffed and have poor continuity of care which may further aggravate post hospitalization follow up. Understanding patient attitudes and perspective on post hospitalization follow up may be important to developing interventions aimed at reducing inpatient readmissions. Few studies have looked at the patient perspective to primary care follow up, and none have looked at this in a resident run clinic.
A qualitative and quantitative survey tool was administered to hospitalized patients known to an outpatient primary care clinic staffed primarily by housestaff and affiliated with a major medical center. Patients had to have been to the clinic within the past 18 months for a primary care appointment, have an assigned primary care physician, speak English or Spanish and lack cognitive difficulties. Patients consented to have their medical record reviewed and were followed after discharge to see if they attended posthospitalization appointments.
A total of 50 patients were surveyed over 5 months. The majority of patients felt it was important to followup with a physician after hospitalization; however 45% felt they only needed to see a specialist, not their PCP. Qualitative analysis identified the following roles of the PCP: referrals, medications, coordination of care, general checkup, and less often followup after hospitalization. In addition, patients expressed specific concerns about their clinic experience including lack of continuity with their PCP. Preliminary data suggest that 25% of these patients did not have followup appointments with their PCP upon discharge and an additional 25% of patients had appointments and did not attend.
Patients at a large urban tertiary medical center who receive their primary care in a resident run clinic appreciate the importance of post discharge follow up, but a large percentage value sub specialty follow up over primary care follow up. Future analysis will determine how these attitudes affect primary care follow up and hospital readmission rates, and if such perspectives differ from patients discharged with attending only PCP follow up.
To cite this abstract:DeFilippo C, Jervis R, Lello T. Do Our Patients Care About Post Hospitalization Follow Up? Perspectives from a Resident Run Clinic. Abstract published at Hospital Medicine 2012, April 1-4, San Diego, Calif. Abstract 97583. Journal of Hospital Medicine. 2012; 7 (suppl 2). https://www.shmabstracts.com/abstract/do-our-patients-care-about-post-hospitalization-follow-up-perspectives-from-a-resident-run-clinic/. Accessed January 20, 2020.