Actual communication occurred in 43.7% of cases and included information on medical assessments (61.9%), psychosocial issues (52.9%), pending tests (34%), and discharge medications (30.9%).
As expected, physician perception of higher medical complexity increased the likelihood of communication. Surprisingly, though psychosocial issues did not predict communication, they were discussed in almost half the cases. Lapses in communication were attributed to lack of time, perceived necessity, and contact information.
The observational nature, nongeneralizable population, and effect of responder bias limit the study. Though an interventional study can better evaluate improvement in patient outcomes, communication at readmission can be used as an educational feedback tool for house staff and attendings.
Bottom line: Modest frequency of communication between discharge and readmission physicians is driven mostly by medical complexity. It bears the potential to improve patient outcomes and offer valuable feedback.
Citation: Roy CL, Kachalia A, Woolf S, Burdick E, Karson A, Gandhi TK. Hospital readmissions: physician awareness and communication practices. J Gen Intern Med. 2009;24(3):374–380. TH