Emergency department visit patterns in the recently discharged, violently injured patient: Retrospective cohort review

• Published in: The American journal of surgery Vol. 225; no. 1; pp. 162 - 167
• Main Authors: Kleber, Kara T., Kravitz-Wirtz, Nicole, Buggs, Shani L., Adams, Christy M., Sardo, Angela C., Hoch, Jeffrey S., Brown, Ian E.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-01-2023; Elsevier Limited
• Subjects: Age; Cost analysis; Cost control; Costs; Demographic variables; Domestic violence; Emergency medical care; Emergency medical services; Emergency Service, Hospital; Ethnicity; Gender; Hispanic Americans; Hospital Costs; Humans; Incidence; Injuries; Injury analysis; Injury prevention; Male; Males; Patient Discharge; Patients; Race; Recidivism; Retrospective Studies; Subgroups; Trauma; Trends
• DOI: 10.1016/j.amjsurg.2022.07.005
• EISSN: 1879-1883
• ISSN: 0002-9610

Analysis of the costs associated with emergency department (ED) visits after discharge for violent injury could highlight subgroups for the development of cost-effective interventions to support healing and prevent treatment failures in violently injured patients.
A retrospective cohort review was conducted of all patients with return ED visits within 90 days of discharge after treatment for a violent injury occurring between July 1, 2016, and June 30, 2018. Hospital costs were calculated for each incidence and analyzed against demographic and injury type variables to identify trends.
218 return ED visits were identified. Hospital costs showed a high frequency of low-cost visits. For more complex visits, distinct cost patterns were observed for Black and LatinX males compared to White males as a function of age.
Analysis of hospital cost per visit identified trends among different subgroups. Underlying etiologies presumably vary between groups, but hypothesis-driven further investigation and needs assessment is required. Understanding the driving forces behind these cost trends may aid in developing effective interventions.
•The analysis of total hospital cost per visit is an effective hypothesis-generating strategy.•Trends in visit cost and frequency suggest clinically distinct groups requiring separate intervention strategies.•High-frequency, low-cost return visits to the emergency department are prevalent.•Older white males demonstrate different cost trends than younger men of color.