Effectiveness of Synchronous Postdischarge Contacts on Health Care Use and Patient Satisfaction : A Systematic Review and Meta-analysis.
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2025-01-14
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BACKGROUND: Postdischarge contacts (PDCs) after hospitalization are common practice, but their effectiveness in reducing use of acute care after discharge remains unclear. PURPOSE: To assess the effects of PDC on 30-day emergency department (ED) visits, 30-day hospital readmissions, and patient satisfaction. DATA SOURCES: MEDLINE, Embase, and CINAHL searched from 2012 to 25 May 2023. STUDY SELECTION: Randomized and nonrandomized trials of PDC within 7 days. DATA EXTRACTION: Two investigators independently screened articles and assessed risk of bias (ROB). Single reviewers extracted data, with verification by second investigators. Random-effects meta-analyses were done on outcomes shared by at least 3 studies, and the certainty of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework. DATA SYNTHESIS: Of 13 included studies (11 randomized trials [RTs]), 12 delivered PDCs via telephone. Three of 11 RTs were rated as having low ROB, with 1 rated high. Most PDC interventions (n = 10) consisted of single telephone contacts, often within 3 days. Eight studies focused on patients identified as higher-risk by the authors. There were no differences in 30-day ED use (5 RTs; 3054 patients; risk difference, 0.00 [95% CI, -0.02 to 0.03]; moderate certainty) or 30-day hospital readmissions (7 RTs; 7075 patients; risk difference, 0.00 [CI, -0.02 to 0.02]; moderate certainty) with PDC. LIMITATION: Adherence and fidelity to PDC interventions were poorly described, and only 1 study investigated nontelephone PDC. CONCLUSION: Postdischarge contacts within 7 days of discharge were not associated with reductions in 30-day ED use or readmissions compared with usual care. Health systems should reconsider the utility of universal PDCs because multifaceted interventions targeting higher-risk patients may be necessary to reduce use of acute care after discharge. PRIMARY FUNDING SOURCE: Department of Veterans Affairs. (PROSPERO: CRD42023465675).
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Boggan, Joel C, Spoorthi Sankineni, Paul A Dennis, Dazhe Chen, Tina Wong Sledge, David Halpern, Sharron Rushton, John W Williams, et al. (2025). Effectiveness of Synchronous Postdischarge Contacts on Health Care Use and Patient Satisfaction : A Systematic Review and Meta-analysis. Ann Intern Med. 10.7326/ANNALS-24-01140 Retrieved from https://hdl.handle.net/10161/31993.
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Scholars@Duke

Joel Boggan
I am a hospital medicine physician interested in quality improvement, patient safety, and medical education across the UME and GME environments. My current projects include work on readmissions, inpatient quality and patient experience measures, appropriate utilization of inpatient resources, systematic reviews of topics related to healthcare quality, and artificial intelligence in medical education. Alongside this work, I serve as the lead mentor for our Durham VA Chief Resident in Quality and Safety within the Department of Medicine and the Program Director for the Duke University Hospital CRQS.
As Associate Program Director for Quality Improvement and Patient Safety in the Duke Internal Medicine Residency Program, I oversee QI and safety education and projects for our residents and help co-lead our Residency Patient Safety and Quality Council. Additionally, I supervise housestaff and students on our general medicine wards, precept housestaff evidence-based medicine resident reports, and serve as a small group leader for our second-year medical student Clinical Skills Course. Finally, I lead our Innovation Sciences thread as part of the ongoing School of Medicine Curriculum Innovation Initiative and serve as a co-course director for our QMDM II (Biostatistics) course.

David Justin Halpern

John Wiley Williams
John Williams, MD, MHS, is a Professor of Medicine at Duke University Medical Center and a past recipient of VA Health Services Career Development and a Robert Wood Johnson Foundation Generalist Faculty Scholar Awards. He received his bachelor and MD degrees from the University of North Carolina. Dr. Williams completed residency training at the University of Iowa and a research fellowship at Duke University. He is a primary care internist who is trained in epidemiology, biostatistics, and literature synthesis. Dr. Williams’ topical interests include depression, mental health services, dementia and implementation of best practices. He is a medical editor for the Patient Centered Outcomes Research Institute and the Evidence-base Practice Program. Dr. Williams is Senior Science Advisor to the Durham VA Evidence Synthesis Program and has led numerous systematic reviews, many focusing on mental health services. Dr. Williams is board certified in Internal Medicine and active in clinical practice and resident physician education at the Durham VAMC.

Tatyana Der

Nathan Adam Boucher
I am a Research Health Scientist at Durham VA Health System’s Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) and Duke University faculty at Sanford School of Public Policy, the Medical School, and the Nursing School. I am also a Senior Fellow at the Duke Center for the Study of Aging & Human Development as well as Duke-Margolis Center for Health Policy Core Faculty.
I have extensive experience in clinical medicine (licensed physician assistant in critical care and emergency medicine), health care administration, health professions education, hospice and palliative care quality improvement, and community-based research. Challenges and opportunities at the intersection of social care and health care inform my research agenda. My collaborations across disciplines at VA and Duke and with community organizations have afforded me deep insights into the lives and challenges of community members and family/friend care partners.
My research has been funded by Veterans Administration, NIH, Centers for Medicare/Medicaid Services, several foundations, and Duke University. Recent research includes 1) describing care partners’ social and health needs related to caring for older adults re-entering the community from prison; 2) designing and testing community health worker programs focused on older adults; 3) characterizing concerns care partners and people living with dementia have regarding the quality of care settings as well as emerging technologies; 4) systems approaches to homelessness among Veterans, and 5) defining and realigning training and employment for NC direct care workers serving in home- and community-based services.
Let's collaborate: nathan.boucher@duke.edu

Sarah Cantrell
Sarah Cantrell (she/her/hers) is the Associate Director for Research & Education at the Medical Center Library & Archives, and is responsible for developing, implementing, and evaluating the Library's research and education programs. She is also the liaison to the Graduate Medical Education programs. Sarah is currently on the steering committee of the Evidence-Based Practice for Health Sciences Librarians workshop, and co-director of the Evidence-Based Practice for the Medical Librarian course at the University of North Carolina at Chapel Hill School of Information and Library Science. Sarah served as a Co-Director of Duke's national Evidence-Based Practice (EBP) workshop for clinicians and librarians from 2019 to 2024. Before joining Duke, she worked at Walter Reed National Military Medical Center in Bethesda, MD, where she established a Clinical Librarian Program and joined inpatient care teams for teaching rounds, providing real-time evidence-based decision support and teaching at the point of care. Prior to WRNMMC, she was the Education Services Coordinator and Instruction Librarian at Georgetown University Medical Center's Dahlgren Memorial Library in Washington, DC.
- MLIS, Library & Information Studies, University of Wisconsin Madison
- BA, English Literature, University of Wisconsin Madison

Karen M. Goldstein
Dr. Goldstein's research interests include women's health, cardiovascular risk reduction, evidence synthesis methodology and peer support.
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