Timeliness of discharge summary and post-discharge adverse events among patients hospitalised for community-acquired pneumonia

BACKGROUND: Whether delayed completion of discharge summary compromises patient safety following hospitalisation for community-acquired pneumonia remains unknown. The objectives of this study were to quantify the timeliness of discharge summary completion and to investigate the relationship between delayed completion of discharge summary and 30-day post-discharge outcomes. METHODS: As part of a cohort study conducted in France, we analysed a sample of 1004 patients (median age, 78 years) discharged alive after a hospitalisation for pneumonia. The primary outcome was defined as a composite adverse event outcome of death or unplanned readmission within 30 days of discharge. We performed inverse probability of treatment weighting analysis based on propensity score to estimate odds ratios (ORs) of 30-day post-discharge adverse events for patients for whom a discharge summary was not completed by the day of discharge. RESULTS: A summary was completed on the day of discharge for 305 patients (30%, 95% confidence interval [CI], 28 to 33). These patients were older, had more severe pneumonia on admission, and were more likely to exhibit impaired functional independence, receive ≥5 concomitant medications, necessitate advanced care and be clinically unstable at discharge. After inverse probability weighting, the 30-day estimates of post-discharge adverse events were 12% and 14% (OR, 1.12; 95% CI, 0.72 to 1.75), with unplanned readmission rates of 9.6% and 10% (OR, 1.09; 95% CI, 0.65 to 1.84) and all-cause mortality rates of 6.9% and 4.3% (OR, 0.61; 95% CI, 0.31 to 1.21) for patients with and without a summary completed on the day of discharge, respectively. CONCLUSIONS: Although this study found no association between delayed completion of discharge summaries and post-discharge adverse events, the availability of a discharge summary in the early follow-up period may enhance other aspects of the quality of care among survivors of hospitalisation for pneumonia.