Low neighborhood income, public or no insurance predict higher ER re-presentation
FRIDAY, Sept. 9 (HealthDay News) -- A substantial percentage of trauma patients, particularly those who are uninsured, publicly insured, or who belong to low-income neighborhoods, re-present to the emergency department within 30 days of discharge from the hospital, but only a small percentage of these need readmission, according to a study published online June 20 in the Annals of Emergency Medicine.
Karim S. Ladha, M.D., from the Johns Hopkins University School of Medicine in Baltimore, and colleagues investigated the rates at which trauma patients re-present to the emergency department after discharge from the hospital, and whether race, insurance, and socioeconomic factors, such as neighborhood income level, are related to re-presentation. A total of 6,675 trauma patients who were admitted to a Level I trauma center between 1997 and 2007, and who re-presented to the hospital were included in the analysis. Neighborhood income was derived through census block data, and missing income data was accounted for by multiple imputations. Predictors of re-presentation were determined by logistic regression analysis.
The investigators found that 886 patients (13.3 percent) returned to the emergency department within 30 days of discharge from the hospital. Compared to patients with commercial insurance, those who were uninsured or publicly insured were more likely to re-present to the emergency department (odds ratio [OR], 1.64 and 1.60, respectively). Living in neighborhoods with an average household income of less than $20,000 correlated with higher odds of re-presentation (OR, 1.77). Of those who re-presented at the emergency department, only 13.2 percent were admitted to the hospital.
"A substantial number of trauma patients return to the emergency department within 30 days of being discharged, but only a small proportion of these patients required readmission," the authors write.
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