Emergency Department Bouncebacks: Is Lack of Primary Care Access the Primary Cause?

Journal Article (Journal Article)

BACKGROUND: National emergency department (ED) bounceback rates within 30 days of previous ED discharge have been found to be as high as 26%. We hypothesize that having a primary care physician (PCP) would prevent bouncebacks to the ED because a patient would have a medical resource for follow-up and continued care. METHODS: We performed a prospective, consecutive, anonymous survey study of adult ED patients at a suburban teaching hospital with 88,000 visits annually, from July 5, 2011 through August 8, 2011. Using chi-squared and Fisher's exact tests, we compared patients with an initial visit to those returning within 30 days of a previous visit to our ED. RESULTS: We collected 1084 surveys. Those in the bounceback group were more likely to have no insurance (10.2% vs. 4.4%) or Medicaid (17.7% vs. 10.8%) and less likely to have a PCP (79% vs. 86%). Of those with a PCP, 9% in both groups had seen their PCP that day, 58% (initial visit) and 49% (bouncebacks) could have been seen that day, and 35% & 36%, respectively, within 1 week. Of those with a PCP, 38% of initial visits and 32% of bouncebacks stated they had already seen their physician at least once. CONCLUSION: Our results suggest that patients who bounce back to the ED might have already contacted their PCP. Although insurance status and the lack thereof predict a higher likelihood to bounce back to the ED, many bouncebacks are insured patients with PCPs able to be seen the same day.

Full Text

Duke Authors

Cited Authors

  • Moskovitz, JB; Ginsberg, Z

Published Date

  • July 2015

Published In

Volume / Issue

  • 49 / 1

Start / End Page

  • 70 - 77.e4

PubMed ID

  • 25862359

International Standard Serial Number (ISSN)

  • 0736-4679

Digital Object Identifier (DOI)

  • 10.1016/j.jemermed.2014.12.030

Language

  • eng

Conference Location

  • United States