Emergency Department Visits After Inpatient Discharge

Providers, payers, and policymakers are increasingly turning their attention to whether the patient returns to the acute care setting at any level (emergency department (ED), observation, or inpatient) within 30 days of inpatient discharge. As efforts to improve care transitions evolve into increasingly cross-setting and community-based strategies, measuring ED visits after inpatient discharge may reveal opportunities to improve care transitions and reduce avoidable acute-level hospital use.

In CHIA's newest report Emergency Department Visits After Inpatient Discharge: SFY2017, CHIA analyzes emergency department (ED) revisits within 30 days of a patient's inpatient discharge. This June 2019 publication includes a comprehensive report, databook, technical appendix, and the key findings below.

Key Findings

• 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.