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Importance of telephone follow-up and combined home visit and telephone follow-up interventions in reducing acute healthcare utilization

Yuan Ying Lee (National University Hospital, Singapore, Singapore)
Lay Hwa Tiew (National University Hospital, Singapore, Singapore)
Yee Kian Tay (National University Hospital, Singapore, Singapore)
John Chee Meng Wong (National University Hospital, Singapore, Singapore)

Journal of Integrated Care

ISSN: 1476-9018

Article publication date: 2 November 2021

Issue publication date: 9 December 2021




Transitional care is increasingly important in reducing readmission rates and length of stay (LOS). Singapore is focusing on transitional care to address the evolving care needs of a multi-morbid ageing population. This study aims to investigate the impact of transitional care programs (TCPs) on acute healthcare utilization.


A retrospective, longitudinal, interventional study was conducted. High-risk patients were enrolled into a transitional care program of local tertiary hospital. Patients received either telephone follow-up (TFU) or home-based intervention (HBI) with TFU. Readmission rates and LOS were assessed for both groups.


There was no statistically significant difference in readmissions or LOS between TFU and HBI. After excluding demised patients, TFU had statistically significant lower LOS than HBI. Both interventions demonstrated statistically significant reductions in readmissions and LOS in pre–post analyses.

Research limitations/implications

TFU may be more effective than HBI in patients with lower clinical severity, despite both interventions showing statistically significant reductions in acute healthcare utilization. Study findings may be used to inform transitional care practices. Future studies should continue to examine the comparative effectiveness of transitional care interventions and the patient populations most likely to benefit.


Previous studies demonstrated promising outcomes for TFU and HBIs, but few have evaluated their comparative effectiveness on acute healthcare utilization and specific patient populations most likely to benefit. This study evaluated interventional effectiveness of both, which might be useful for informing allocation of resources based on clinical complexity and care needs.



Lee, Y.Y., Tiew, L.H., Tay, Y.K. and Wong, J.C.M. (2021), "Importance of telephone follow-up and combined home visit and telephone follow-up interventions in reducing acute healthcare utilization", Journal of Integrated Care, Vol. 29 No. 4, pp. 403-413.



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