|Patients treated in emergency rooms make far more repeat visits than previously thought, a new study has revealed, although they often go to a different ER the second time around.
Analysis of more than 53 million ER records from between 2006 and 2010 (the latest data available) showed that around 8% of the patients were back in an emergency department within three days. About 20% of patients made a repeat visit within a month.
Patients with skin infections had the highest rate of return, followed by patients with abdominal pain.
These types of “big data” studies have been facilitated only relatively recently because of the rapid adoption of electronic health records; adoption of basic EHR systems by office-based physicians went up 21% between 2012 and 2013 alone, and the industry is slated to be worth nearly $30 billion by 2022.
But unfortunately, national health systems are still disconnected in many ways, meaning those same records often aren’t available to practitioners at different health facilities.
That could even be part of the reason why patients end up back in the ER, the study authors suggest; it’s likely that their primary care managers never even know that they’ve made ER trips, meaning they don’t get the follow-up care that they need.
And in reverse, ER doctors may not have access to tests or diagnostic scans from previous visits, meaning they have to order them again. That drives up the costs of healthcare, as well as overloading facilities and delaying treatment.
The federal government has been trying to enforce the adoption of EHRs among hospitals and doctors that receive reimbursement from Medicare and Medicaid, but numerous problems with implementation have forced regulators to back off and allow more time for providers to comply. That means it could be even longer before all health institutions have records that allow for easy communication among practitioners.
This study used data from Arizona, California, Florida, Hawaii, Nebraska and Utah, some of the first states to link records so that they follow patients from one health facility to another.
The findings were published this month in the journal Annals of Internal Medicine.