Association Between Early Versus Delayed Outpatient Follow-Up After Hospital Discharge and Short-Term Healthcare Utilization Among ICU Survivors

Background: Intensive care unit (ICU) survivors experience high rates of healthcare utilization after hospital discharge, including readmissions and emergency department (ED) visits. Timely outpatient follow-up has been proposed to improve care transitions, but its impact on critically ill populations remains uncertain. Objective: To assess whether early outpatient follow-up within three days compared with delayed follow-up between seven and 14 days after discharge is associated with differences in 30-day healthcare utilization among adult ICU survivors. Methods: This retrospective cohort study used data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, including linked ED records. Adult ICU survivors discharged from the hospital were included. The exposure was the timing of the first post-discharge outpatient follow-up, defined as the first scheduled outpatient visit after discharge and categorized as early or delayed. ED visits and hospital readmissions were not included in the exposure definition. Outcomes were 30-day hospital readmission and ED visit. Multivariable logistic regression was used to evaluate associations, adjusting for demographic and clinical variables. Results: A total of 10,123 patients were included. Early follow-up was not associated with differences in 30-day readmission or ED visits compared with delayed follow-up. Higher comorbidity burden and illness severity were associated with increased readmission risk, while exposure timing showed no significant association with either outcome. Conclusions: Early outpatient follow-up alone may not be associated with differences in short-term healthcare utilization among ICU survivors, although residual confounding and potential biases should be considered. More comprehensive post-discharge care strategies may be needed.