Evaluating Hospital Readmissions Through the Perspective of the Returning Emergency Department Patient

Background and Objective: Hospital readmissions have garnered attention over the last few years. The reasons are myriad, including penalties from the Centers for Medicare & Medicaid Services, as well as acknowledgment from hospitals that readmissions highlight failures in the treatment spectrum. The purpose of this project was to investigate patients' perspective of why they return to the emergency department (ED) within 30 days of discharge from the inpatient setting. Methods: A descriptive qualitative study was conducted in an attempt to elucidate causes of readmissions in our patient population. Detailed interviews of 80 patients who returned to the ED within 30 days of discharge were completed to determine patients' health status upon discharge, ability to obtain resources, and health status that prompted return for care. Results: Of the 80 patients who returned, 64 were admitted to the hospital. The median time from discharge to return was 13.4 days. Pain was the most common reason for return to the ED. Of the 80 patients, only 19 followed up with a physician prior to return. Conclusions: The data show that once patients return to the ED after discharge, it is very likely they will be admitted to the hospital. An intervention prior to the return to the ED is imperative.