Factors Affecting the Likelihood of Presentation to the Emergency Department of Trauma Patients After Discharge

Overview

Journal Ann Emerg Med

Specialty Emergency Medicine

Date 2011 Jun 22

PMID 21689864

Citations 20

Authors

Karim S Ladha

J Hunter Young

Derek K Ng

David T Efron

Adil H Haider

Affiliations

Soon will be listed here.

Abstract

Study Objective: We determine the rate at which trauma patients re-present to the emergency department (ED) after discharge from the hospital and determine whether re-presentation is related to race, insurance, and socioeconomic factors such as neighborhood income level.

Methods: Trauma patients admitted to a Level I trauma center between January 1, 1997, and December 31, 2007, were identified with the hospital's trauma registry. These patients were linked to administrative data to obtain information about re-presentation to the hospital. Neighborhood income was obtained with census block data; multiple imputation was implemented to account for missing income data. Logistic regression analysis was used to determine the predictors of re-presentation.

Results: There were 6,675 patients who were included in the study. A total of 886 patients (13.3%) returned to the ED within 30 days of discharge from the hospital. Uninsured patients (odds ratio [OR]=1.64; 95% confidence interval [CI] 1.30 to 2.06) and publicly insured patients (OR=1.60; 95% CI 1.20 to 2.14) were more likely to re-present to the ED than those with commercial insurance. Residing in a neighborhood with a median household income less than $20,000 was associated with a higher odds of re-presentation (OR=1.77; 95% CI 1.37 to 2.29). Only 13.2% of patients who came to the ED were readmitted to the hospital.

Conclusion: A substantial number of trauma patients return to the ED within 30 days of being discharged, but only a small proportion of these patients required readmission. Re-presentation is associated with being uninsured or underinsured and with lower neighborhood income level.

Citing Articles

Characterizing a Common Phenomenon: Why do Trauma Patients Re-present to the Emergency Department?.

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Scheduled Follow-Up and Association with Emergency Department Use and Readmission after Trauma.

Smith S, Zhao X, Kenzik K, Michael C, Jenkins K, Sanchez S J Am Coll Surg. 2024; 239(3):234-241.

PMID: 38629706 PMC: 11539589. DOI: 10.1097/XCS.0000000000001094.

Risk factors for loss to follow-up after traumatic injury: An updated view of a chronic problem.

Smith S, Zhao X, Kenzik K, Michael C, Jenkins K, Sanchez S Surgery. 2024; 175(5):1445-1453.

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Measuring Health Equity in Emergency Care Using Routinely Collected Data: A Systematic Review.

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Victims of Violence and Post-Discharge Adverse Events: A Prospective Modified Trauma Quality Improvement Program (TQIP) Study.

Gontarz B, Siddiqui U, McGuiness C, Doben A, Jayaraman V, Mclaughlin E Cureus. 2021; 13(10):e18630.

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