Geography, Not Health System Affiliations, Determines Patients' Revisits to the Emergency Department.

Publication/Presentation Date

4-1-2018

Abstract

OBJECTIVES: To determine how frequently patients revisit the emergency department after an initial encounter, and to describe revisit capture rates for the same hospital, health system, and geographic region.

DATA SOURCES/STUDY SETTING: Florida state data from January 1, 2010, to June 30, 2011, from the Healthcare Cost and Utilization Project.

STUDY DESIGN: This is a retrospective cohort study of emergency department return visits among Florida adults over an 18-month period. We evaluated pairs of index and 30-day return emergency department visits and compared capture rates for hospital, health system, and geographic units.

DATA COLLECTION/EXTRACTION METHODS: Data were obtained from the Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project and the American Hospital Association Annual Survey Database.

PRINCIPAL FINDINGS: Among 9,416,212 emergency department visits, 22.6 percent (2,124,441) were associated with a 30-day return. Seventy percent (1,477,772) of 30-day returns occurred to the same hospital. The 30-day return capture rates were highest within the same geographic area: county-level capture at 92 percent (IQR=86-96 percent) versus health system capture at 75 percent (IQR = 68-81 percent).

CONCLUSIONS: Acute care utilization patterns are often independent of health system boundaries. Current population-based health care models that attribute patients to a single provider or health system may be strengthened by considering geographic patterns of acute care utilization.

Volume

53

Issue

2

First Page

1092

Last Page

1109

ISSN

1475-6773

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

28105730

Department(s)

Administration and Leadership

Document Type

Article

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