OBJECTIVE: To identify the frequency of, and risk factors for, repeat emergency department (ED) visits and hospitalizations following a treat-andrelease ED visit in patients from Veterans Affairs Medical Centers (VAMCs). STUDY DESIGN: Retrospective cohort study. METHODS: Subjects were veterans who visited 1 of 102 VAMC EDs between October 1, 2007, and June 30, 2008. Generalized estimating equations were used to identify factors related to repeat ED visits and hospitalizations within 30 days of the index ED visit. RESULTS: At their index ED visit, 80% of veterans were treated and released. Of these, 15% returned to the ED and 5% were hospitalized in the next 30 days. In adjusted= models, factors associated with increased odds of repeat ED visits included homelessness (odds ratio [OR] 1.70; 95% confidence interval [CI] 1.59, 1.82) and having a previous ED visit (OR 1.66; 95% CI 1.58, 1.74). Odds of hospitalization were higher among older (OR 1.35; 95% CI 1.26, 1.46), homeless (OR 1.61; 95% CI 1.44,.,and functionally impaired (OR 1.52; 95% CI 1.35, 1.76) veterans, those with greater comorbidity (OR 1.31; 95% CI 1.27, 1.34), previous hospitalization (OR 2.48; 95% CI 2.28, 2.70), and an original ED visit related to a chronic condition (OR 1.30; 95% CI 1.23, 1.37). Among veterans who returned to the ED, 71.7% did not see another VA outpatient provider between their original and return visits. CONCLUSIONS: A substantial proportion of veterans treated and released from VAMC EDs returned to the ED or were hospitalized within 30 days.
OBJECTIVE: To identify the frequency of, and risk factors for, repeat emergency department (ED) visits and hospitalizations following a treat-andrelease ED visit in patients from Veterans Affairs Medical Centers (VAMCs). STUDY DESIGN: Retrospective cohort study. METHODS: Subjects were veterans who visited 1 of 102 VAMC EDs between October 1, 2007, and June 30, 2008. Generalized estimating equations were used to identify factors related to repeat ED visits and hospitalizations within 30 days of the index ED visit. RESULTS: At their index ED visit, 80% of veterans were treated and released. Of these, 15% returned to the ED and 5% were hospitalized in the next 30 days. In adjusted= models, factors associated with increased odds of repeat ED visits included homelessness (odds ratio [OR] 1.70; 95% confidence interval [CI] 1.59, 1.82) and having a previous ED visit (OR 1.66; 95% CI 1.58, 1.74). Odds of hospitalization were higher among older (OR 1.35; 95% CI 1.26, 1.46), homeless (OR 1.61; 95% CI 1.44,.,and functionally impaired (OR 1.52; 95% CI 1.35, 1.76) veterans, those with greater comorbidity (OR 1.31; 95% CI 1.27, 1.34), previous hospitalization (OR 2.48; 95% CI 2.28, 2.70), and an original ED visit related to a chronic condition (OR 1.30; 95% CI 1.23, 1.37). Among veterans who returned to the ED, 71.7% did not see another VA outpatient provider between their original and return visits. CONCLUSIONS: A substantial proportion of veterans treated and released from VAMC EDs returned to the ED or were hospitalized within 30 days.
Authors: Susan N Hastings; Karen M Stechuchak; Cynthia J Coffman; Elizabeth P Mahanna; Morris Weinberger; Courtney H Van Houtven; Kenneth E Schmader; Cristina C Hendrix; Chad Kessler; Jaime M Hughes; Katherine Ramos; G Darryl Wieland; Madeline Weiner; Katina Robinson; Eugene Oddone Journal: J Gen Intern Med Date: 2019-09-05 Impact factor: 5.128
Authors: Michael L Barnett; Xinhua Zhao; Michael J Fine; Carolyn T Thorpe; Florentina E Sileanu; John P Cashy; Maria K Mor; Thomas R Radomski; Leslie R M Hausmann; Chester B Good; Walid F Gellad Journal: J Gen Intern Med Date: 2019-05-29 Impact factor: 5.128
Authors: Wesley C Holland; Katherine M Hunold; Sowmya A Mangipudi; Alison M Rittenberg; Natalie Yosipovitch; Timothy F Platts-Mills Journal: Acad Emerg Med Date: 2016-02-13 Impact factor: 3.451
Authors: Amal N Trivedi; Lan Jiang; Erin E Johnson; Julie C Lima; Michael Flores; Thomas P O'Toole Journal: Health Serv Res Date: 2018-08-27 Impact factor: 3.402