{"pk":10609,"title":"Predictors of Return Visits Among Insured Emergency Department Mental Health and Substance Abuse Patients, 2005-2013","subtitle":null,"abstract":"Introduction:\n Our goal was to describe the pattern and identify risk factors of early-return ED visits orinpatient admissions following an index mental health and substance abuse (MHSA)-related ED visit in theUnited States.\nMethods:\n We performed a retrospective cohort study using Optum Labs Data Warehouse, a nationallyrepresentative database containing administrative claims data on privately insured and MedicareAdvantage enrollees. Authors identified patients presenting to an ED with a primary diagnosis of MHSAbetween 2005 and 2013 who were discharged home. Study inclusion required continuous insuranceenrollment for the 12 months preceding and the 31 days following the index ED visit. During the studyperiod we included only the first ED visit for each patient.\nResults:\n A total of 49,672 (14.2%) had a return visit to the ED or had a hospitalization within 30 daysfollowing discharge. Mean time to the next ED visit or inpatient admission was 11.7 days. An increasedage (age 65+ vs. age <18 years; OR 1.65, 95% CI [1.57 to 1.74]), chronic medical comorbidities (Hwangcomorbidity 5+ vs 0; OR 1.31, 95% CI [1.27 to 1.35]), prior ED and inpatient utilization (4+ visits vs 0 visits;OR 5.59, 95% CI [5.41 to 5.78]) were associated with return visits within 30 days following discharge.\nConclusion:\n In an analysis of nearly 350,000 ED visits for MHSA, 14.2 % of patients returned to the ED orhospital within 30 days. This study identified a number of factors associated with return visits for acute care.[West J Emerg Med. 2017;18(5)884-893.]","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Mental health and substance abuse, Claim data, Return visits"}],"section":"Behavioral Health","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3tn3x0w2","frozenauthors":[{"first_name":"Sangil","middle_name":"","last_name":"Lee","name_suffix":"","institution":"The University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa","department":"None"},{"first_name":"Jeph","middle_name":"","last_name":"Herrin","name_suffix":"","institution":"Yale University School of Medicine, Department of Cardiology, New Havens, Connecticut\nHealth Research & Educational Trust, Chicago, Illinois","department":"None"},{"first_name":"William","middle_name":"V.","last_name":"Bobo","name_suffix":"","institution":"Mayo Clinic, Department of Psychiatry, Rochester, Minnesota","department":"None"},{"first_name":"Ryan","middle_name":"","last_name":"Johnson","name_suffix":"","institution":"Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, Minnesota","department":"None"},{"first_name":"Lindsey","middle_name":"R.","last_name":"Sangaralingha","name_suffix":"","institution":"Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, Minnesota","department":"None"},{"first_name":"Ronna","middle_name":"L.","last_name":"Campbell","name_suffix":"","institution":"Mayo Clinic, Department of Emergency Medicine, Rochester, Minnesota","department":"None"}],"date_submitted":"2017-02-07T11:30:58Z","date_accepted":"2017-02-07T11:30:58Z","date_published":"2017-07-17T15:29:41Z","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/10609/galley/5817/download/"}]}