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Uninsured trauma patients are more likely to use the ED for follow-up care
Date:8/25/2011

Providing access to an outpatient clinic isn't enough to keep some trauma patients who have been discharged from the hospital from returning to the emergency department (ED) for follow-up care, even for such minor needs as pain medication refills and dressing changes, according to new Johns Hopkins research.

Reporting in the Annals of Emergency Medicine, the researchers say that patients with Medicaid, Medicare and those with no insurance were 60 percent more likely to seek such care in the ED. Those living in poor neighborhoods were 70 percent more likely than patients with insurance to head to the ED instead of going to a doctor's office or clinic.

The findings suggest that, for reasons that are not well understood, many patients who could receive less expensive outpatient care won't or can't seek it, the Hopkins team says. These patients, the researchers say, end up receiving far more costly care in the ED, where they have longer waits and add to the notorious crowding that burdens many emergency rooms.

"Just providing patients access to doctors outside of the ER clearly isn't working, especially for those without insurance," says study leader Adil H. Haider, M.D., M.P.H., an assistant professor of surgery at the Johns Hopkins University School of Medicine. "We need better ways to help patients discharged from the hospital receive appropriate follow-up care."

Haider and his colleagues analyzed the records of 6,675 trauma patients admitted to The Johns Hopkins Hospital between 1997 and 2007. Roughly 13 percent of these patients returned to the ED within a month of discharge, yet nearly 90 percent of them were not readmitted into the hospital, suggesting that their ER visit was avoidable and that they could have been treated in an outpatient clinic, Haider says. Among the small number of return patients who were readmitted, the main cause was complications from their original injury and hospitalization.


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Contact: Stephanie Desmon
sdesmon1@jhmi.edu
410-955-8665
Johns Hopkins Medical Institutions
Source:Eurekalert

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