Emergency department visits by persons recently discharged from U.S. hospitals.

BACKGROUND: Emergency department (ED) visits are rarely used as an outcome of prior hospitalization, but could be an indicator of poor inpatient care or follow-up planning.

STUDY OBJECTIVE: To examine the rate and characteristics of ED visits of patients recently discharged from any hospital.

METHODS: Data from the 2005 and 2006 National Hospital Ambulatory Medical Care Surveys (NHAMCS) and National Hospital Discharge Surveys (NHDS) were used to produce ratios of the numbers of ED visits where patients were discharged from any hospital within the last 7 days to the numbers of hospital discharges. NHAMCS, an annual survey of visits to U.S. hospital EDs, reported data for patients discharged from any hospital within 7 days previous to the ED visit. The NHDS is an annual survey of inpatient discharges from U.S. hospitals. Data from nonnewborn patients were weighted to produce national estimates.

RESULTS: About 2.3 million ED visits (2.0 percent of all visits) were made by persons who had been hospitalized within the last 7 days. This corresponds to 68 ED visits per 1000 live hospital discharges. About 10 percent of patients at these ED visits presented with medical or surgical complications that may have been related to their recent hospitalization. Uninsured persons were nearly three times as likely as those privately insured to make an ED visit following hospital discharge.

CONCLUSION: A large number of ED visits following recent hospitalization may be related to prior hospitalization. Returning to the ED after hospitalization may be an important measure to help improve inpatient care quality. Disparities in rates of ED visits following hospitalization may be attributed to differential inpatient or follow-up care.