News: Early outpatient follow-up unassociated with hospital-free survival post AMI, study finds

Early outpatient follow-up was not associated with differences in hospital-free survival or risk of decline in health-related quality of life (HR-QoL) among older adults after acute myocardial infarction (AMI), according to a retrospective study published in the Journal of Hospital Medicine.

The study noted that outpatient follow-up within a week after hospitalization for AMI is endorsed by the American College of Cardiology and national guidelines. However, there is conflicting evidence of its benefits for older patients. There is also a lack of information about how early outpatient follow-up impacts patient-centered outcomes by helping with patient satisfaction, medication, optimization, and symptom management. The authors hypothesized that early outpatient follow-up would be associated with improved outcomes at 180 days post-discharge.

The authors examined data from 2013 to 2016 on more than 15,000 older patients after AMI. Based on this, the authors then identified the first ambulatory visits after hospital discharge among this group by CPT codes that indicated in-person, office-based visits involving evaluation and management (i.e., CPT codes 99201-99245, 99324-99350, 99387, and 99397). The patients were then categorized by when they had their follow-up visit post-discharge: within seven days (44.2%), within eight to14 days (25.7%), or no visit within 14 days (30%).

Researchers then looked at what percentage of each category of patients remained free from readmission, emergency department visits, or death 180 days post-discharge: those within seven days (50.8%), within eight to14 days (48%), or no visit within 14 days (51.5%).

Early outpatient follow-up was also found to not significantly be associated with hospital-free survival nor HR-QoL 180-days post-discharge. It declined 33.8% among patients with follow-up within seven days, 33.8% among those with follow-up within eight to14 days, and 27.6% among those with no early outpatient follow-up.

The study’s limitations included a lack of details about the follow-up visits and not capturing potential longer-term impacts of early outpatient follow-up beyond six months post-discharge. However, the study also points to growing evidence that early outpatient follow-up may not be the correct target for improving post-AMI outcomes.

Editor’s note: To read the full study, click here. To read additional coverage from JustCoding, click here.