{"id":3273,"date":"2015-06-05T15:00:00","date_gmt":"2015-06-05T15:00:00","guid":{"rendered":"http:\/\/www.emlitofnote.com\/?p=3273"},"modified":"2015-06-05T15:00:00","modified_gmt":"2015-06-05T15:00:00","slug":"your-bouncebacks-are-not-alone","status":"publish","type":"post","link":"https:\/\/www.emlitofnote.com\/?p=3273","title":{"rendered":"Your Bouncebacks Are Not Alone"},"content":{"rendered":"<p>\u201cRemember that patient you had yesterday?\u201d is infrequently a favorable start to a conversation. &nbsp;Emergency Department bouncebacks are frequently tracked metric, ostensibly for self-reflection, but also as a proxy for care quality and mismanagement.<\/p>\n<p>This is a 6 state review of 2 to 5 years of data linked between State Emergency Department Databases and State Inpatient Databases, evaluating Emergency Department recidivism up to 30 days. &nbsp;The authors also linked this data to healthcare cost data, but highest quality cut of meat here is the detail on bouncebacks. &nbsp;Based on 53,530,443 Emergency Department visits, these authors found the overall 3-day revisit rate was 8.2%, and the 30-day revisit rate was 19.9%. &nbsp;Approximately 2\/3rds of revisits were to the same Emergency Department, with the remainder choosing a different ED.<\/p>\n<p>These numbers, I think, are much higher than most would expect \u2013 and provide at least a small amount of solace if you feel as though it seems there&#8217;s always a previous patient of yours checking back into the ED. &nbsp;The authors break down several interesting details regarding the types of revisits:<\/p>\n<ul>\n<li>Skin and soft-tissue infections resulted in 23.1% 3-day revisit rates, with 12.9% admission on revisit.<\/li>\n<li>Abdominal pain was the second-most frequent revisit, at 9.7%, associated with 29.9% admission on revisit.<\/li>\n<li>Patients aged 18-44 were more likely to visit a different ED for the second visit, while patients aged 65 and above were the most likely to be admitted on revisit.<\/li>\n<li>Patient with back pain had the highest revisit rate to a different ED within 3 days, 7.8%, with 41% of those visiting a different ED.<\/li>\n<\/ul>\n<p>Simply at face value, these additional visits are expensive and resource-intensive \u2013 particularly if there\u2019s not an effective local electronic information exchange preventing duplication of testing. &nbsp;There is also clearly ample opportunity to develop targeted interventions for certain groups of patients to potentially provide follow-up care in a lower-cost setting.<\/p>\n<p>\u201cRevisit Rates and Associated Costs After an Emergency Department Encounter\u201d<br \/><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/26030633\">http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/26030633<\/a><\/p>\n\n<div class=\"twitter-share\"><a href=\"https:\/\/twitter.com\/intent\/tweet?via=emlitofnote\" class=\"twitter-share-button\">Tweet<\/a><\/div>\n","protected":false},"excerpt":{"rendered":"<p>\u201cRemember that patient you had yesterday?\u201d is infrequently a favorable start to a conversation. &nbsp;Emergency Department bouncebacks are frequently tracked metric, ostensibly for self-reflection, but also as a proxy for care quality and mismanagement. This is a 6 state review of 2 to 5 years of data linked between State Emergency Department Databases and State &hellip; <a href=\"https:\/\/www.emlitofnote.com\/?p=3273\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;Your Bouncebacks Are Not Alone&#8221;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[11],"tags":[],"class_list":["post-3273","post","type-post","status-publish","format-standard","hentry","category-quality"],"jetpack_publicize_connections":[],"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p7KesJ-QN","jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/posts\/3273","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3273"}],"version-history":[{"count":0,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/posts\/3273\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3273"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3273"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3273"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}