CHIA Publishes Report on ED Visits after Inpatient Discharge

DATE: June 6, 2019

CHIA has released a comprehensive examination of emergency department (ED) visits after inpatient discharge in Massachusetts acute care hospitals. This report expands upon CHIA's readmissions analysis, capturing inpatient discharges that are followed by an ED visit.

Providers, payers, and policymakers are increasingly turning their attention to whether the patient returns to the acute care setting at any level (ED, observation, or inpatient). The ED is a costly setting to receive care, and patients visiting the ED in the post-hospital discharge period may represent an opportunity to improve care. As efforts to facilitate better care transitions evolve, measuring the rate of ED visits after inpatient discharge may reveal opportunities to reduce avoidable acute-level hospital use.   

• In State Fiscal Year 2017, 26.4% of inpatient discharges were followed by a return to the ED within 30 days.
   
• There was wide variation in 30-day revisit rates among Massachusetts acute care hospitals, ranging from a low of 20.9% to a high of 35.9%.  
   
• Among all 30-day revisits, rates were highest for adults under age 65, specifically patients whose primary expected payer was Medicaid or Medicare.
   
• Psychiatric and substance use-related conditions were among those with the highest rates of 30-day revisits.

 

This report is also accompanied by a databook and technical appendix.