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LetterCorrespondence

Re: Timely Outpatient Follow-Up Is Associated with Fewer Hospital Readmissions Among Patients with Behavioral Health Conditions

Ayodeji Otufowora
The Journal of the American Board of Family Medicine September 2019, 32 (5) 754-755; DOI: https://doi.org/10.3122/jabfm.2019.05.190172
Ayodeji Otufowora
Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL
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To the Editor: I commend Dr Nadareh Pourat and colleagues1 for their important work on timely outpatient follow-up and hospital readmissions among patients with behavioral health conditions. I do, however, have a few concerns.

First, the concept of trust in the doctor-patient relationship is an essential one that affects clinical outcomes,2 while distrust has been associated with treatment discordance.3 Thus, patients that were dissatisfied with the inpatient care during the index admission may not be predisposed to attend follow-up or comply with treatment. It would have been informative if their regression models accounted for patient's trust in their health care providers and how it may affect compliance with follow-up, especially in this patient population.

Second, although the authors admirably adjusted for many confounders in their regression models, I wonder if Pourat and colleagues1 considered controlling for anxiety or homelessness/unstable housing, both of which are drivers of hospitalization and readmissions.4,5 It may be interesting and revealing to assess compliance with follow-ups in homeless individuals with behavioral health conditions, such as anxiety disorders, and how both factors might affect timely follow-up outpatient visits.

Acknowledgments

The author is thankful to his research mentor Dr. Linda Cottler for her support.

Notes

  • To see this article online, please go to: http://jabfm.org/content/32/5/000.full.

  • The above letter was referred to the author of the article in question, who declined to respond.

References

  1. 1.↵
    1. Pourat N,
    2. Chen X,
    3. Wu S-H,
    4. Davis AC
    . Timely outpatient follow-up is associated with fewer hospital readmissions among patients with behavioral health conditions. J Am Board Fam Med. 2019;32:353–61.
    OpenUrlAbstract/FREE Full Text
  2. 2.↵
    1. Birkhäuer J,
    2. Gaab J,
    3. Kossowsky J,
    4. et al
    . Trust in the health care professional and health outcome: a meta-analysis. PLoS One. 2017;12:e0170988.
    OpenUrl
  3. 3.↵
    1. Dean LT,
    2. Moss SL,
    3. McCarthy AM,
    4. Armstrong K
    . Healthcare system distrust, physician trust, and patient discordance with adjuvant breast cancer treatment recommendations. Cancer Epidemiol Biomarkers Prev. 2017;26:1745–1752.
    OpenUrlAbstract/FREE Full Text
  4. 4.↵
    1. Masson C,
    2. Sorensen J,
    3. Phibbs C,
    4. Okin RL
    . Predictors of medical service utilization among individuals with co-occurring HIV infection and substance abuse disorders. AIDS Care. 16:744–55.
  5. 5.↵
    1. Raven MC,
    2. Billings JC,
    3. Goldfrank LR,
    4. Manheimer ED,
    5. Gourevitch MN
    . Medicaid patients at high risk for frequent hospital admission: real-time identification and remediable risks. J Urban Heal. 2009;86:230–41.
    OpenUrl
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The Journal of the American Board of Family     Medicine: 32 (5)
The Journal of the American Board of Family Medicine
Vol. 32, Issue 5
September-October 2019
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Re: Timely Outpatient Follow-Up Is Associated with Fewer Hospital Readmissions Among Patients with Behavioral Health Conditions
Ayodeji Otufowora
The Journal of the American Board of Family Medicine Sep 2019, 32 (5) 754-755; DOI: 10.3122/jabfm.2019.05.190172

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Re: Timely Outpatient Follow-Up Is Associated with Fewer Hospital Readmissions Among Patients with Behavioral Health Conditions
Ayodeji Otufowora
The Journal of the American Board of Family Medicine Sep 2019, 32 (5) 754-755; DOI: 10.3122/jabfm.2019.05.190172
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