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Outcomes Explored for ER Return Visit Hospital Admissions

Patients initially discharged then readmitted after return ER visit have lower in-hospital mortality

WEDNESDAY, Feb. 17, 2016 (HealthDay News) — Patients with emergency department visits who are initially discharged and are then admitted at a return visit have better clinical outcomes that those hospitalized at the index emergency department visit without a return visit, according to a study published in the Feb. 16 issue of the Journal of the American Medical Association.

Amber K. Sabbatini, M.D., M.P.H., from the University of Washington in Seattle, and colleagues examined in-hospital clinical outcomes and resource use among patients hospitalized during an unscheduled return visit to the emergency department. The authors identified and followed patients with index emergency department visits for return visits within seven, 14, and 30 days.

The researchers found that patients discharged from the emergency department and admitted to the hospital after a return visit within seven days had significantly lower rates of in-hospital mortality, intensive care unit (ICU) admission, lower mean costs, and longer length of stay than patients who were admitted during the index emergency department visit without a return visit. Compared with patients admitted to the hospital during the index emergency department visit without a return visit, those who returned to the emergency department after discharge and were readmitted had higher rates of in-hospital mortality and ICU admission, longer lengths of stay, and higher costs.

“Hospital admissions associated with return visits to the emergency department may not adequately capture deficits in the quality of care delivered during an emergency department visit,” the authors write.

One author disclosed financial ties to Blue Cross Blue Shield of Michigan/Blue Cross Network.

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