Evaluating Automated Post-Discharge Outreach Among Surgical Patients Using Retrospective EHR Data and Complementary Causal Methods
Year: 2026
Type: preprint
Study design: Observational Study
Abstract: Objective: Challenges exist in providing adequate post-discharge recovery and care transitions for surgical patients, with often inconsistent manual outreach. The objective of this study is to evaluate an automated post-discharge outreach program as a replacement to manual outreach on 30-day unplanned readmissions and ED visits among surgical patients. Study Setting and Design: We conducted a retrospective observational study using EHR data with complementary group and individual-level analyses. Marginal structural models with inverse probability of treatment weighting methods and difference-in-differences methods and were used for the individual and group-level analyses, respectively. Data sources and Analytic Sample: We used EHR data on adult surgical patients discharged from a large integrated health system in Pennsylvania before and after implementation of an automated outreach program. Principal Findings: Automated outreach was not associated with a meaningful overall change in 30- day unplanned readmissions (RR=1.03, 95% CI: 0.93, 1.13), with similar null findings for ED visits in the individual-level analysis. Subgroup analyses suggested heterogeneity by surgical specialty and patient type, including lower readmission risk among urologic surgery patients (RR=0.52, 95% CI: 0.34, 0.80) and a modestly lower risk among inpatient discharges (RR=0.89, 95% CI: 0.80, 1.00), but higher readmission risk among bariatric surgery patients (RR=1.42, 95% CI: 1.08, 1.86), who received outreach later than the other groups. Group-level difference-in-differences analyses also showed no clear overall effect on readmissions or ED visits, with estimates near zero across multiple timeperiod and staggered adoption models. Conclusions: Automated post-discharge outreach was not associated with overall reductions in 30- day unplanned readmissions or ED visits among surgical patients, although effects may vary across subgroups. These findings suggest that automated outreach may be most useful as a scalable strategy to standardize post-discharge monitoring and replace manual outreach rather than as a universal approach to reducing utilization after surgical discharge. Combining individual-level and group-level analytic approaches provided convergent evidence and may offer a practical framework for evaluating health system interventions implemented in routine care.
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7204024103
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