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{
    "pk": 12647,
    "title": "Predicting Emergency Department “Bouncebacks”: A Retrospective Cohort Analysis",
    "subtitle": null,
    "abstract": "Introduction:\n The short-term return visit rate among patients discharged from emergency departments (ED) is a quality metric and target for interventions. The ability to accurately identify which patients are more likely to revisit the ED could allow EDs and health systems to develop more focused interventions, but efforts to reduce revisits have not yet found success. Whether patients with a high number of ED visits are at increased risk of a return visit remains underexplored.\nMethods:\n This was a population-based, retrospective, cohort study using administrative data from a large physician partnership. We included patients discharged from EDs from 80 hospitals in seven states from July 2014 – June 2016. We performed multivariable logistic regression of short-term return visits on patient, visit, hospital, and community characteristics. The primary outcome was the proportion of patients who had a return visit within 14 days of an index ED visit.\nResults:\n Among 6,699,717 index visits, the overall risk of 14-day revisit was 12.6%. Frequent visitors accounted for 18.7% of all visits and 40.2% of all 14-day revisits. Frequent visitor status was associated with the highest odds of a revisit (odds ratio [OR] 3.06; 95% confidence interval [CI], 3.041 – 3.073). Other predictors of revisits were cellulitis (OR 2.131; 95% CI, 2.106 – 2.156), alcohol-related disorders (OR 1.579; 95%CI, 1.548 – 1.610), congestive heart failure (OR 1.175; 95% CI, 1.126 – 1.226), and public insurance (Medicaid OR 1.514; 95% CI, 1.501 – 1.528; Medicare OR 1.601; 95% CI, 1.583 – 1.620).\nConclusion:\n Previous ED use – even a single previous visit – was a stronger predictor of a return visit than any other patient, hospital, or community characteristic. Clinicians should consider previous ED use when considering treatment decisions and risk of return visit, as should stakeholders targeting patients at risk of a return visit.",
    "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": "Emergency Medicine"
        },
        {
            "word": "Frequent Users"
        },
        {
            "word": "bouncebacks"
        }
    ],
    "section": "Emergency Department Operations",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/70h7b7z3",
    "frozenauthors": [
        {
            "first_name": "Juan Carlos",
            "middle_name": "C.",
            "last_name": "Montoy",
            "name_suffix": "",
            "institution": "University of California, San Francisco, Department of Emergency Medicine, San Francisco, California",
            "department": "None"
        },
        {
            "first_name": "Joshua",
            "middle_name": "",
            "last_name": "Tamayo-Sarver",
            "name_suffix": "",
            "institution": "Vituity Healthcare, Emeryville, California",
            "department": "None"
        },
        {
            "first_name": "Gregg",
            "middle_name": "A.",
            "last_name": "Miller",
            "name_suffix": "",
            "institution": "Vituity Healthcare, Emeryville, California",
            "department": "None"
        },
        {
            "first_name": "Amy",
            "middle_name": "E.",
            "last_name": "Baer",
            "name_suffix": "",
            "institution": "Vituity Healthcare, Emeryville, California",
            "department": "None"
        },
        {
            "first_name": "Christopher",
            "middle_name": "R.",
            "last_name": "Peabody",
            "name_suffix": "",
            "institution": "University of California, San Francisco, Department of Emergency Medicine, San Francisco, California",
            "department": "None"
        }
    ],
    "date_submitted": "2019-03-27T21:55:54Z",
    "date_accepted": "2019-03-27T21:55:54Z",
    "date_published": "2019-10-16T22:11:44Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/12647/galley/6691/download/"
        }
    ]
}