Therefore, in this study we aimed to describe frequency and patient attributes associated with ED visits within 30 days of inpatient discharge in a Portuguese health region–Algarve. Recent data indicate that only after the covid-19 pandemic there was a clear reduction in the volume of ED visits in Portugal. Additionally, 39% of triaged ED care visits in Portugal during 2019 had a low clinical priority. In 2011, there were over 70 ED visits per 100 population, while OECD (Organisation for Economic Co-operation and Development) countries average was 31. Despite being a global concern, this problem has particular relevance in Portugal, since there is a high use of ED care. Due to its open-door policy, patients may see ED as a convenient way to access care, but its episodic nature may increase the number of providers caring for each patient and the risk of care fragmentation. A small flat rate is required to patients visiting ED, but around 60% of the population is exempted due to clinical and/or economic reasons and no previous referral is necessary. In Portugal, health care provision is mainly ensured by a tax-funded National Health Service. A study at NHS hospitals in England, including chronic obstructive pulmonary disorder and heart failure patients, found that 1 in 5 returned to hospital within 30 days and that for nearly a quarter of ED visits there was no readmission. described that nearly a third of all admissions received acute post-discharge care in observation units or the emergency department (heart failure: 30.7% acute myocardial infarction: 26.9% pneumonia: 24.8%) in 2008–16. The percentage of patients with at least one ED visit within 30 days of discharge varied between 21.7% (non-targeted conditions) and 26.4% (targeted conditions) in a study also aiming to study the effects of Medicare’s Hospital Readmissions Reduction Program. identified 1,064,410 revisits (treat-and-discharge visit to ED, observation stay, and readmission) in the 30 days after 3,038,740 discharges of patients aged 65 years or over admitted for heart failure, acute myocardial infarction, or pneumonia. Data on ED utilization shortly after discharge is comparatively scarce and mostly from US. Despite its relevance, these readmissions fail to capture the care of patients that visit emergency department (ED) after discharge and return home. Inpatient care readmissions have been receiving considerable attention, mostly since their inclusion in pay-for-performance schemes in several countries. Also, some initiatives to improve care coordination after discharge have decreased the risk of readmission, even if improvements are not consistent. Fragmented care after discharge has been associated with greater gaps in quality, more preventable hospitalizations, and decreased quality of life. In order to respond to these increased needs, healthcare systems globally aim to ensure safe transitions of care when patients move from an acute care setting to home or to other provider. Data are available from the Ethics Committee (contact via for researchers who meet the criteria for access to confidential data.įunding: The authors received no specific funding for this work.Ĭompeting interests: The authors have declared that no competing interests exist.Īfter being discharged from hospital, patients experience a period of increased vulnerability that places them at increased risk of adverse events, known as “post-hospital syndrome”. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: Data cannot be shared publicly because of privacy. Received: JanuAccepted: SeptemPublished: October 14, 2022Ĭopyright: © 2022 Salgado et al. PLoS ONE 17(10):Įditor: Jingjing Qian, Auburn University, UNITED STATES Citation: Salgado R, Moita B, Lopes S (2022) Frequency and patient attributes associated with emergency department visits after discharge: Retrospective cohort study.
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