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Emergency department visits in veterans affairs medical facilities

Publication ,  Journal Article
Hastings, SN; Smith, VA; Weinberger, M; Schmader, KE; Olsen, MK; Oddone, EZ
Published in: American Journal of Managed Care
June 1, 2011

Objective: To identify the frequency of, and risk factors for, repeat emergency department (ED) visits and hospitalizations following a treat-and-release ED visit in patients from Veterans Affairs Medical Centers (VAMCs). Study Design: Retrospective cohort study. Methods: Subjects were veterans who visited 1 of 102 VAMC EDs between October 1, 2007, and June 30, 2008. Generalized estimating equations were used to identify factors related to repeat ED visits and hospitalizations within 30 days of the index ED visit. Results: At their index ED visit, 80% of veterans were treated and released. Of these, 15% returned to the ED and 5% were hospitalized in the next 30 days. In adjusted models, factors associated with increased odds of repeat ED visits included homelessness (odds ratio [OR] 1.70; 95% confidence interval [CI] 1.59, 1.82) and having a previous ED visit (OR 1.66; 95% CI 1.58, 1.74). Odds of hospitalization were higher among older (OR 1.35; 95% CI 1.26, 1.46), homeless (OR 1.61; 95% CI 1.44, 1.80), and functionally impaired (OR 1.52; 95% CI 1.35, 1.76) veterans, those with greater comorbidity (OR 1.31; 95% CI 1.27, 1.34), previous hospitalization (OR 2.48; 95% CI 2.28, 2.70), and an original ED visit related to a chronic condition (OR 1.30; 95% CI 1.23, 1.37). Among veterans who returned to the ED, 71.7% did not see another VA outpatient provider between their original and return visits. Conclusions: A substantial proportion of veterans treated and released from VAMC EDs returned to the ED or were hospitalized within 30 days. © Managed Care & Healthcare Communications, LLC.

Duke Scholars

Published In

American Journal of Managed Care

ISSN

1088-0224

Publication Date

June 1, 2011

Volume

17

Issue

6

Related Subject Headings

  • Health Policy & Services
  • 4203 Health services and systems
  • 1117 Public Health and Health Services
 

Citation

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Hastings, S. N., Smith, V. A., Weinberger, M., Schmader, K. E., Olsen, M. K., & Oddone, E. Z. (2011). Emergency department visits in veterans affairs medical facilities. American Journal of Managed Care, 17(6).
Hastings, S. N., V. A. Smith, M. Weinberger, K. E. Schmader, M. K. Olsen, and E. Z. Oddone. “Emergency department visits in veterans affairs medical facilities.” American Journal of Managed Care 17, no. 6 (June 1, 2011).
Hastings SN, Smith VA, Weinberger M, Schmader KE, Olsen MK, Oddone EZ. Emergency department visits in veterans affairs medical facilities. American Journal of Managed Care. 2011 Jun 1;17(6).
Hastings, S. N., et al. “Emergency department visits in veterans affairs medical facilities.” American Journal of Managed Care, vol. 17, no. 6, June 2011.
Hastings SN, Smith VA, Weinberger M, Schmader KE, Olsen MK, Oddone EZ. Emergency department visits in veterans affairs medical facilities. American Journal of Managed Care. 2011 Jun 1;17(6).

Published In

American Journal of Managed Care

ISSN

1088-0224

Publication Date

June 1, 2011

Volume

17

Issue

6

Related Subject Headings

  • Health Policy & Services
  • 4203 Health services and systems
  • 1117 Public Health and Health Services