Emergency department visits following discharge: Implications for healthcare management

Abstract

Objective: This study aimed to reveal the frequency of emergency department (ED) visits within 7 and 30 days after discharge and to identify the factors affecting these ED visits. Methods: A total of 1570 patients discharged from the internal medicine wards of a university hospital in Turkey within 1 year were included in this prospective cohort study. Multiple logistic regression analyses were used to identify the factors affecting ED visits. Results: Of the patients, 1.3% visited the ED within the first 7 days after discharge and 5.2% within 30 days. Multivariable analyses showed that the probability of an ED visit within 30 days was 1.83 (95% CI 1.09-3.08; p = 0.023) times higher for male patients and 2.15 (95% CI 1.00-4.60; p = 0.049) times higher for patients with intensive care unit (ICU) stay before discharge. The probability of an ED visit increased by 1.25 (95% CI 1.11-1.42, p < 0.001) times for every 1-point increase in the comorbidity score. The costs of ED visits within 0-7 days were lower than the costs within 8-30 days (p = 0.001). Conclusion: Innovative approaches targeting discharge planning and postdischarge care for patients with high comorbidity scores and ICU use during index hospitalization could reduce ED visits within 30 days after discharge.