Abstract
Background
National emergency department (ED) bounceback rates within 30 days of previous ED
discharge have been found to be as high as 26%. We hypothesize that having a primary
care physician (PCP) would prevent bouncebacks to the ED because a patient would have
a medical resource for follow-up and continued care.
Methods
We performed a prospective, consecutive, anonymous survey study of adult ED patients
at a suburban teaching hospital with 88,000 visits annually, from July 5, 2011 through
August 8, 2011. Using chi-squared and Fisher's exact tests, we compared patients with
an initial visit to those returning within 30 days of a previous visit to our ED.
Results
We collected 1084 surveys. Those in the bounceback group were more likely to have
no insurance (10.2% vs. 4.4%) or Medicaid (17.7% vs. 10.8%) and less likely to have
a PCP (79% vs. 86%). Of those with a PCP, 9% in both groups had seen their PCP that
day, 58% (initial visit) and 49% (bouncebacks) could have been seen that day, and
35% & 36%, respectively, within 1 week. Of those with a PCP, 38% of initial visits
and 32% of bouncebacks stated they had already seen their physician at least once.
Conclusion
Our results suggest that patients who bounce back to the ED might have already contacted
their PCP. Although insurance status and the lack thereof predict a higher likelihood
to bounce back to the ED, many bouncebacks are insured patients with PCPs able to
be seen the same day.
Keywords
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Article info
Publication history
Published online: April 07, 2015
Accepted:
December 21,
2014
Received in revised form:
November 26,
2014
Received:
May 20,
2014
Footnotes
Institutional Review Board (IRB) approval was acquired from the North Shore University Hospital IRB committee.
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
