title: Inpatient Readmissions and Emergency Department Visits within 30 Days of a Hospital Admission.
abstract: BACKGROUND
  Inpatient hospital readmissions have become a focus for healthcare reform and cost-containment efforts. Initiatives targeting unanticipated readmissions have included care coordination for specific high readmission diseases and patients and health coaching during the post-discharge transition period. However, little research has focused on emergency department (ED) visits following an inpatient admission. The objective of this study was to assess 30-day ED utilization and all-cause readmissions following a hospital admission.
  
  
  METHODS
  This was a retrospective study using inpatient and ED utilization data from two hospitals with a shared patient population in 2011. We assessed the 30-day ED visit rate and 30-day readmission rate and compared patient characteristics among individuals with 30-day inpatient readmissions, 30-day ED discharges, and no 30-day visits.
  
  
  RESULTS
  There were 13,449 patients who met the criteria of an index visit. Overall, 2,453 (18.2%) patients had an ED visit within 30 days of an inpatient stay. However, only 55.6% (n=1,363) of these patients were admitted at one of these 30-day visits, resulting in a 30-day all-cause readmission rate of 10.1%.
  
  
  CONCLUSIONS
  Approximately one in five patients presented to the ED within 30 days of an inpatient hospitalization and over half of these patients were readmitted. Readmission measures that incorporate ED visits following an inpatient stay might better inform interventions to reduce avoidable readmissions.
authors.affiliation: University of California, San Diego, Department of Emergency Medicine, San Diego, California.
authors.forename: Jesse J
authors.initials: JJ
authors.lastname: Brennan
authors.affiliation: University of California, San Diego, Department of Emergency Medicine, San Diego, California.
authors.forename: Theodore C
authors.initials: TC
authors.lastname: Chan
authors.affiliation: University of California, San Diego, Department of Emergency Medicine, San Diego, California.
authors.forename: James P
authors.initials: JP
authors.lastname: Killeen
authors.affiliation: University of California, San Diego, Department of Emergency Medicine, San Diego, California.
authors.forename: Edward M
authors.initials: EM
authors.lastname: Castillo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006764:Hospitals, Community / Q000706:statistics & numerical data; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007348:Insurance, Health / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018881:Suburban Health / Q000706:statistics & numerical data; D013997:Time Factors; D014193:Trauma Centers / Q000706:statistics & numerical data; D014481:United States; D014504:Urban Health / Q000706:statistics & numerical data; D055815:Young Adult