To conduct their study, the researchers analyzed adult ED visits during 2013 to acute care hospitals in Florida and New York using data from the Healthcare Cost and Utilization Project. They identified patients’ initial ED visit and any return visits to the ED within seven, 14 and 30 days.
Highlighted below are 10 takeaways from the study.
1. Among more than 9.04 million initial ED visits to 424 hospitals in the study sample, approximately 1.76 million patients were admitted to the hospital during their first ED visit.
2. Of the patients admitted on their first ED visit, 8.5 percent had a return visit to the ED within seven days of the first ED visit, 13 percent within 14 days and 19.9 percent within 30 days.
3. The hospital readmission rates for the patients who returned to the ED within seven days, 14 days and 30 days were 51 percent, 53.4 percent and 54.6 percent, respectively.
4. Among the 7.28 million patients who were discharged during their initial ED visit, 8.2 had a return visit to the ED within seven days, 11.5 percent within 14 days and 16.6 percent within 30 days.
5. Of these patients, 14.4 percent were admitted to the hospital within seven days, 14.5 percent within 14 days and 14.4 percent within 30 days.
6. The patients who were initially discharged from the ED and then admitted to the hospital during a return ED visit within seven days had significantly lower rates of inpatient mortality (1.85 percent) compared with the patients who were admitted during the first ED visit without a return ED visit (2.48 percent).
7. The patients who were discharged and then returned within a week also experienced lower rates of ICU admission (23.3 percent versus 29 percent), lower average costs ($10,169 versus $10,799) and longer lengths of stay (5.16 days versus 4.97 days) than those who were admitted during the first ED visit without a return ED visit.
8. Similar patterns were observed for patients returning to the ED within 14 and 30 days of the initial ED visit.
9. In contrast, patients who returned to the ED after hospital discharge and were readmitted had higher rates of inpatient mortality and ICU admission, longer lengths of stay and higher costs during the repeat hospital admission compared with those admitted to the hospital during the first ED visit without a return ED visit.
10. The study authors concluded, “These findings suggest that hospital admissions associated with return visits to the ED may not adequately capture deficits in the quality of care delivered during an ED visit.”
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