Visit to GP after hospital reduces risk of readmission

The RACGP is pushing for a simple incentive scheme to encourage GP visits within seven days of hospital discharge

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The RACGP is pushing for a simple incentive scheme to encourage patients to see their GP within seven days of being discharged from hospital.

The proposal, which will form part of the College’s submission to the MBS review, comes on the back of a recent American study, which found that a visit to a GP within seven days of a hospital admission reduced the risk of a readmission within 30 days of discharge by 12% to 24%.

“That’s the evidence policymakers should be taking notice of,” RACGP President Dr Bastian Seidel told TMR.

The study, published in JAMA Internal Medicine, involved more than 71,000 patients.

“[The study] shows if you get patients in very early to see their GP, the chance of getting readmitted is significantly less,” Dr Seidel said. “Again, it fits in nicely with the idea that the more you see your GP, the less likely you are going to end up in hospital.”

Hospital readmissions that could have been avoided cost the Australian healthcare system around more than $3 billion per year every year, according to the RACGP.

“Imagine the cost savings by providing an incentive to see a GP within seven days of a hospital presentation,” Dr Seidel said.

An MBS item for a post-hospital visit within seven days could provide an incentive for patients and GPs to organise an appointment, a practice which is currently not common.

“Why not double the MBS rebate for item 23/36/44 for patients who are seen within seven days?” Dr Seidel suggested.

Better remuneration also would encourage GPs to leave appointments open for post-hospital discharge consultations.

“As a GP you would know [your patient was in hospital] as you get an admission notification,” he said.

“If you know that five patients have been admitted for various reasons per week over the last three months, you just leave five visits per week open in your schedule.

“Patients would probably be quite happy to come in to see the GP within seven days of discharge,” he said.

This policy could be implemented in a very short timeframe because there was no need for any “fancy bureaucracy”, Dr Seidel said.

The US study did not examine the reasons GP visits significantly cut hospital readmission rates.

But the authors suggested the GP consultations were likely to keep patients out of hospital because they allowed for the assessment of clinical status, treatment intensification, follow-up for pending test results and referrals, medication review and patient and family education.

“It is tying up those loose ends. That’s the main thing,” Dr Seidel said. “Making sure patients are within their treatment regime, patients have enough medication, patients are following the discharge advice.”

See your GP as soon as you’ve been discharged from hospital, and you’re less likely to be re-admitted. Simple as that. #auspol pic.twitter.com/aOcYqe98MB

— Dr Bastian Seidel (@DrBastianSeidel) November 22, 2016

JAMA Internal Medicine 2016, online November 21