Impact of post-discharge calls on patient outcomes and healthcare utilization: A real-world hospital-based study

Abstract

Background: Post-discharge calls (PDCs) are increasingly implemented to improve continuity of care, patient engagement, and early identification of post-discharge complications. However, real-world evidence demonstrating their effectiveness across multiple departments remains limited.

Objective: To evaluate the impact of post-discharge calls on patient outcomes, healthcare utilization, and mortality among patients who reported complaints within 30 days of hospital discharge in 2024 (From January to December).

Methods: This observational study analyzed data from patients across three units and fifteen departments of a tertiary care multispeciality hospital. Patients who raised complaints within 30 days of discharge were followed through PDC by care managers who are trained nurses with a standard questions reviewed by nursing heads and approved by the consultants. Outcomes assessed included hospital visits, emergency readmissions, complaint resolution mode, elective readmissions, and mortality during the follow-up period.

Results: Among 11,000 patients, a total of 215 (1.95%) patients reported postdischarge complaints within 1 month of discharge. Of these, 161 (74.9%) required hospital visits, while 22 (10.2%) were resolved telephonically. Common reasons for emergency readmission included breathing difficulty (28.4%), fever (21.9%), and pain (14.0%). PDCs facilitated planned elective readmissions, most commonly for CABG (n=170), and chemotherapy (n=149), blood transfusion (n=140). Overall mortality was observed in 48 patients predominantly among elderly patients and those with chronic illness.

Conclusion: Post-discharge calls play a significant role in early detection of complications, facilitating timely elective readmissions, and optimizing post-hospital care. PDCs represent an effective care coordination strategy, particularly for patients
with chronic and complex conditions.