Examining predictors of utilization of an Interdisciplinary outpatient transitions of care service

Abstract

Objective To determine the impact of need, enabling and predisposing factors on utilization of an interdisciplinary, postdischarge transitions of care (TOC) service. Methods This was a retrospective cohort study of patients discharged from an acute care hospital and scheduled for a TOC visit. Patients with a scheduled TOC appointment at the study clinic within 30 days of a hospital discharge from any of the three University of Pennsylvania Health System hospitals in Philadelphia between September 2013 and January 2015 were included in the study. Individual determinants of healthcare utilization from the Andersen model were extracted from the patients' electronic health record chart. Bivariate analyses were used to identify patient characteristics associated with utilizing the TOC service. A logistic regression model was used to identify independent predictors of TOC service utilization. Key findings TOC utilizers had higher Charlson Comorbidity Index (CCI) scores (OR 1.66, P < 0.01), greater number of internal medicine office visits (OR 1.20, P = 0.03) and took fewer medications (OR 0.89, P < 0.01) relative to non-utilizers. Conclusions Findings from this study can help healthcare administrators prioritize factors associated with the greatest impact on utilization with the ultimate goal of increasing utility of TOC services.