Emergency Departments Can Affect Hospital Readmission Rates, Massive EHR Study Shows
New research finds that some hospitals do more than others to prevent post-surgical readmissions from the emergency department (ED). The study, published in the Journal of Surgical Research, analyzed the electronic health records of 1.95 million Medicare beneficiaries to see if hospitals with high readmission rates also have increased rates of post-discharge ED visits. "Emergency departments are a significant factor in preventing readmission," said lead author Dr. Sharmistha Dev, research scientist at the Regenstrief Institute. "Coordination of care should involve the ED." The team studied patients who underwent one of five common surgical procedures — percutaneous coronary intervention, colectomy, hip replacement, coronary artery bypass grafting, and aortic valve repair or replacement — at nearly 2,900 hospitals between 2008 and 2011. According to the data, there was wide variation in 30-day post-discharge readmission rates across the hospitals, though the rates of ED visits post-surgery were relatively similar. But at hospitals with very high readmission rates, the proportion of patients readmitted from the ED was nearly three times higher compared to those with low readmission rates. The rate of readmission within a week of ED discharge was not higher at hospitals with a low percentage of patients readmitted from the ED, however, indicating that some EDs and their affiliated providers may provide care that prevents readmissions without an accompanying short-term risk of readmission after discharge from the ED. "Our immediate next steps are to perform a deep dive into the practices of the best and worst performing hospitals and emergency departments," Dev said.
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