ER Visits Frequent Within 30-Days of Hospital Discharge

And, 30-day readmission common after hospitalization for heart failure, acute MI, pneumonia

TUESDAY, Jan. 22 (HealthDay News) -- Emergency department visits account for almost 40 percent of post-discharge acute care encounters; and readmissions within 30-days occur in a considerable proportion of patients hospitalized with heart failure, acute myocardial infarction (MI), and pneumonia, according to two studies published in the Jan. 23/30 issue of the Journal of the American Medical Association.

Anita A. Vashi, M.D., M.P.H., from the Yale University School of Medicine in New Haven, Conn., and colleagues examined the role of emergency department visits and hospital readmissions in the use of acute care services within 30 days of discharge in a cohort of 5,032,254 index hospitalizations among 4,028,555 unique patients. The researchers found that emergency department visits comprised 39.8 percent of the 1,233,402 post-discharge acute care encounters. In the 30 days following discharge, there were 97.5 emergency department treat-and-release visits and 147.6 hospital readmissions for every 1,000 discharges.

Kumar Dharmarajan, M.D., M.B.A., from the Columbia University Medical Center in New York City, and colleagues examined patterns of readmission among Medicare beneficiaries within 30 days after hospitalization for heart failure, acute MI, or pneumonia. The researchers found that 24.8, 19.9, and 18.3 percent, respectively, were readmitted within 30 days. The proportions readmitted with the same condition were 35.2, 10.0, and 22.4 percent, respectively. The majority of readmissions occurred within 15 days of hospitalization.

"This heightened vulnerability of recently hospitalized patients to a broad spectrum of conditions throughout the post-discharge period favors a generalized approach to preventing readmissions that is broadly applicable across potential readmission diagnoses and effective for at least the full month after hospitalization," Dharmarajan and colleagues write.

Two authors from the Vashi study disclosed financial ties to FAIR Health Inc. Several authors from the Dharmarajan study disclosed financial ties to the pharmaceutical industry.

Abstract - Vashi
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Abstract - Dharmarajan
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