Don't ignore ED visits after discharge in readmission data

While nearly a quarter of discharged hospital inpatients end up in the emergency department within 30 days, hospitals ignore the significance of those visits because fewer than half result in readmission, a new study concludes.

Considering ED visits as a return to an acute-care setting could help hospitals "intervene in a cycle of frequent rehospitalizations," researchers from the University of Pennsylvania reported in the study published online this week in the Annals of Emergency Medicine.

"By limiting the focus of hospital readmissions measurement to only inpatient-to-inpatient events and omitting ED visits shortly after hospital discharge, researchers and policymakers may be missing a substantial source of return-to-acute health care use that is managed solely in the ED," the researchers wrote, according to Kaiser Health News.

To better understand what leads to subsequent healthcare use among discharged patients, hospitals should home in on ED use within 30 days of discharge, the authors noted.

The highest readmission rate (83 percent) occurred among patients with congestive heart failure, MedPage Today reported. Congestive heart failure also was the most common diagnosis among discharged patients visiting the ED, at 32 percent, followed by diabetes complications (31 percent).

"As efforts to improve care transitions evolve into increasingly cross-setting and community-based strategies, measuring the rate of emergency department visits after inpatient discharge may reveal opportunities to improve care transitions and reduce avoidable acute-level use," the researchers wrote, according to MedPage Today.

They suggested hospitals consider alternatives to the ED for patients seeking care within the 30-day discharge window.

To learn more:
- read the study abstract
- check out the Kaiser Health News article
- here's the MedPage Today article