【摘要】目的对门诊患者进行及时随访是降低患者再入院率的关键策略。在出院后 30 d 内再入院患者中,有一半未在出院后进行随访。对于病情多变且复杂的患者,应通过指导确定出院后随访的最佳时机。方法本研究据北卡罗来纳州医疗补助索赔数据,获取 2012 年4月—2013 年3月出院的患者资料。构建反映患者是否进行有间隔的连 【Abstract】 Objective To timely follow-up of outpatients is a key strategy to reduce the rate of hospital admission. Half of those who returned within 30 days after discharge were not followed up after discharge. For patients with variable and complex conditions, the best time to follow-up after discharge should be determined through guidance. Methods This study used data from North Carolina Medicaid claims to obtain patient data for discharge from April 2012 to March 2013. Build to reflect whether patients with even the interval even