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Discharged hospital patients often returned through ED within 30 days

Almost 18% of hospitalized patients returned to an emergency department within 30 days of discharge, according to recent data.

Researchers examined records for 5 million patients from acute care hospitals in California, Florida and Nebraska in 2008-2009. Following hospital discharge, 17.9% (95% CI, 17.9%-18%) of patients returned to the ED or were readmitted within 30 days. The study also found that ED visits were 39.8% (95% CI, 39.7-39.9%) of post-discharge encounters with acute care.

“Clinicians and policymakers may be underestimating the extent of patients’ hospital-based acute care needs after hospital discharge,” the researchers wrote.

Of the patients who returned to the hospital, approximately one-third (35.3%) returned within 7 days of discharge, and 57.4% returned within 14 days. Among all the returning patients, approximately 57% were admitted through the ED.

Among the most prevalent reasons for 30-day post-discharge visits to the ED (encounters/1,000 discharges) or for hospital-based acute care were:

Medical conditions

• Psychosis: 219.4 (95% CI, 217.2-221.5)
• Digestive disorders: 140.7 (95% CI, 138.1-143.3)

Surgical conditions

• Complicated cesarean delivery: 84.6 (95% CI, 82.2-87)
• Complicated laparoscopic cholecystectomy: 84.5 (95% CI, 81.3-87.8)

Hospital-based acute care

• Psychosis: 470.8 (95% CI, 467.7-474)
• Heart failure: 373.5 (95% CI, 370-377)

“Focusing solely on readmissions would have missed nearly half a million ED treat-and-release encounters in these three states and substantially underestimated acute care use following medical and surgical inpatient discharges,” the researchers concluded.

Disclosure: See the study for a full list of relevant disclosures.