Key result
In 2018, approximately 97 million of 130 million US emergency department visits resulted in a referral for follow-up care, with higher rates among females, Black patients, and Medicaid/CHIP beneficiaries.
Why the study?
The study was conducted to describe characteristics of patient visits resulting in referrals for follow-up medical care after discharge from hospital emergency departments.
What are the patient and visit characteristics associated with higher rates of referrals for follow-up medical care after emergency department discharge?
Cross-Sectional (n=130,000,000)
Yes
What are the patient and visit characteristics associated with higher rates of referrals for follow-up medical care after emergency department discharge?
In 2018, nearly 75% of US emergency department visits resulted in a referral for follow-up care, with significant disparities observed by sex, race, and insurance status.
Referral patterns after ED discharge vary by patient characteristics; hypothesis-generating for care transitions, should not yet change practice.
Objective: To describe characteristics of a nationally representative sample of patient visits that ended with a referral for follow-up medical care after discharge from hospital emergency department (ED) visits. Methods: We used 2018 National Hospital Ambulatory Medical Care Survey data to identify patient characteristics associated with higher rates of visits with referrals for follow-up medical care after ED discharge from nonfederal short-stay and general hospitals throughout the United States. Referral included categories of all disposition variables that indicated referral to a source of care consistent with the patient's clinical condition at ED discharge. Results: Approximately 97 million of 130 million visits (29 700/100 000 US resident population) were referred for follow-up medical care during 2018. Visit referral rates were higher among females (33 100) than among males (26 300/100 000 population); higher among Black patients (61 700) than among White patients (25 600/100 000 population); highest in the South (33 200/100 000 population); and similar rates in Nonmetropolitan (29 900/100 000 population) and Metropolitan Statistical Areas (30 200/100 000 population). Visit referral rates were higher for patients with Medicaid/Children's Health Insurance Program (CHIP) (66 900) than those with Medicare (31 500) or private insurance (14 000/100 000 population). Abnormal clinical findings and injuries were the discharge diagnoses most often referred for follow-up medical care. Conclusion: Higher visit referral rates were observed among female sex, non-Hispanic Black race, Medicaid/CHIP, abnormal clinical findings, and injuries. Future studies might reveal reasons that prompted higher referral rates among various patients' characteristics.
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Adekoya et al. (2022) conducted a cross-sectional in Emergency department visits (n=130,000,000). Patient characteristics (e.g., female sex, Black race, Medicaid/CHIP) vs. Other patient characteristics (e.g., male sex, White race, Medicare/private insurance) was evaluated on Referral for follow-up medical care after ED discharge. In 2018, approximately 97 million of 130 million US emergency department visits resulted in a referral for follow-up care, with higher rates among females, Black patients, and Medicaid/CHIP beneficiaries.
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