title: Association between early returns and frequent ED visits at a rural academic medical center.
abstract: The objective of this study was to examine the influence of frequent emergency department (ED) use on early returns to the ED at a large rural academic medical center. An analysis was done of all 35,440 visits by 22,442 individuals to a large rural academic medical center ED during calendar year 2000. Of 35,440 ED visits, there were 1,992 (5.62%) return visits within 72 hours (early return). Frequent ED visits (visits made by individuals making 4 or more visits per year) was a predictor of early return visits (odds ratio [OR] 3.21, 95% confidence interval [CI] 2.93-3.52; Wald chi(2), P <.0001). Of 22,442 individuals who came to the ED during the study period, 1,601 (7.13%) returned within 72 hours. Frequency of ED use by a particular individual (4 or more visits per year) was also a predictor of early return for that individual (OR 14.55, 95% CI 12.84-16.48; Wald chi(2), P <.000001). The high rate of early returns to this rural academic ED was significantly associated with frequent visits (4 or more times per year) to the ED by particular individual.
authors.affiliation: Department of Emergency Medicine, West Virginia University School of Medicine, Morgantown, WV, USA. jriggs@wvu.edu
authors.forename: Jack E
authors.initials: JE
authors.lastname: Riggs
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Davis
authors.forename: Gerald R
authors.initials: GR
authors.lastname: Hobbs
authors.forename: Debra J
authors.initials: DJ
authors.lastname: Paulson
authors.forename: Ann S
authors.initials: AS
authors.lastname: Chinnis
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Heilman
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006300:Health Services Misuse / Q000706:statistics & numerical data; D006801:Humans; D016017:Odds Ratio; D010343:Patient Admission / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D019233:Retreatment / Q000706:statistics & numerical data*; D019035:Rural Health Services / Q000706:statistics & numerical data*; D013997:Time Factors; D014600:Utilization Review / Q000706:statistics & numerical data*