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Edgar Allan Poe/Sullivan's Island Library
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West Ashley Library
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Miss Jane's Building (Edisto Library Temporary Location)
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Dorchester Road Library
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Phone: (843) 552-6466
John L. Dart Library
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Phone: (843) 722-7550
Baxter-Patrick James Island
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Timing and Location of Emergency Department Revisits.
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- Author(s): Michelson, Kenneth A.; Lyons, Todd W.; Bachur, Richard G.; Monuteaux, Michael C.; Finkelstein, Jonathan A.
- Source:
Pediatrics. May2018, Vol. 141 Issue 5, p1-8. 8p. - Source:
- Additional Information
- Subject Terms:
- Subject Terms:
- Abstract: BACKGROUND: Emergency department (ED) revisits are used as a measure of care quality.Many EDs measure only revisits to the same facility, underestimating true rates. We sought to determine the frequency, location, and predictors of ED revisits to the same or a different ED. METHODS: We studied ED discharges for children <18 years old in Maryland and New York in the statewide ED and inpatient databases. Revisits were defined as ED visits within 7 days of an index visit. Our primary outcome was the proportion of revisits that were different-hospital revisits (DHRs). We measured the underestimation of total revisits when only same-hospital revisits were measured. We determined the risk of DHR by quartile of annual ED pediatric volume, adjusting for case mix, insurance, state, and urban location. RESULTS: Revisits across 261 EDs occurred after 5.9% of 4.3 million discharges. A per-ED median 21.9% of revisits were DHRs (interquartile range 14.2%-34.6%). Measuring only same-hospital revisits underestimated total revisits by 17.4%. The proportions of revisits that were DHRs by increasing volume quartile were 28.1%, 25.5%, 22.6%, and 14.5%. The adjusted risk of DHR was lower for increasing quartiles of pediatric volume (adjusted odds ratio for highest versus lowest quartile 0.27; 95% confidence interval, 0.19-0.36). CONCLUSIONS: Measuring ED revisits only at the index ED significantly underestimates total revisits. Lower pediatric volume is associated with higher DHRs as a proportion of revisits. When using revisits as a measure of emergency care quality, effort should be made to assess revisits to different EDs. [ABSTRACT FROM AUTHOR]
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