Evaluation of Telehealth Services on Emergency Department Re Attendance Rates

Summary: Unplanned re-attendance at the Emergency Department (ED) exacerbates hospital overcrowding, strains resources, and raises healthcare costs. In response to these challenges, an audit of post-ED discharge telehealth services was conducted to evaluate its impact on re-attendance rates at a tertiary hospital in Singapore. This audit analyzed data from the service provided between January 1 and December 31, 2022. In this initiative, patients were contacted by trained tele-callers within 96 hours of discharge from the ED. Those who answered the call formed the intervention arm while those who did not answer formed the control group. A total of 17,355 ED visits were reviewed, with re-attendance rates within seven and 14 days post-discharge serving as the main outcome. A logistic regression model adjusted for potential confounding variables, including gender, race, age, short-stay unit utilization, ambulance utilization, musculoskeletal conditions, GP referral, abscondment, and previous ED or inpatient admission before the index visit was used. The re-attendance rate in the intervention group was 74.2 per 1,000 compared to 101.1 per 1,000 in the control group. Patients in the intervention group had significantly lower odds of re-attendance within 3 to 7 days (OR=0.78, 95% CI 0.65, 0.93) and within three to 14 days (OR=0.84, 95% CI 0.73, 0.98). Additionally, increased healthcare utilization in the three months before the index visit was associated with higher odds of re-attendance. The implementation of telehealth follow-up services significantly reduced ED re-attendance rates up to 14 days post-discharge. The findings underscore the vital role of telehealth services in managing hospital capacity by reducing re-attendance, thereby enabling more efficient use of resources. The results from this review support the continued integration as a strategy to optimize healthcare delivery.