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

Kara T Kleber; Nicole Kravitz-Wirtz; Shani L Buggs; Christy M Adams; Angela C Sardo; Jeffrey S Hoch; Ian E Brown

doi:10.1016/j.amjsurg.2022.07.005

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

Am J Surg. 2023 Jan;225(1):162-167. doi: 10.1016/j.amjsurg.2022.07.005. Epub 2022 Jul 20.

Authors

Kara T Kleber¹, Nicole Kravitz-Wirtz², Shani L Buggs³, Christy M Adams⁴, Angela C Sardo⁵, Jeffrey S Hoch⁶, Ian E Brown⁷

Affiliations

¹ Department of Surgery, University of California Davis School of Medicine, 235 Stockton Blvd, Sacramento, CA, 95817, USA. Electronic address: Ktkleber@UCDavis.edu.
² Violence Prevention Research Program, Department of Emergency Medicine, University of California Davis School of Medicine, 2315 Stockton Blvd, Sacramento, CA, 95817, USA. Electronic address: nkravitzwirtz@ucdavis.edu.
³ Violence Prevention Research Program, Department of Emergency Medicine, University of California Davis School of Medicine, 2315 Stockton Blvd, Sacramento, CA, 95817, USA. Electronic address: sabuggs@ucdavis.edu.
⁴ Trauma Prevention Program, UC Davis Health, University of California Davis, 4900 Broadway, Suite 1650, Sacramento, CA, 95820, USA. Electronic address: cmadams@ucdavis.edu.
⁵ University of California Davis School of Medicine, 4610 X St, Sacramento, CA, 95817, USA. Electronic address: asardo@ucdavis.edu.
⁶ Division of Health Policy and Management, Department of Public Health Sciences and Center for Healthcare Policy and Research, University of California Davis, 4900 Broadway, Suite 1430, Sacramento, CA, 95820, USA. Electronic address: jshoch@ucdavis.edu.
⁷ Division of Trauma, Acute Care Surgery, and Surgical Critical Care, Department of Surgery University of California Davis Medical Center, 2335 Stockton Blvd, Sacramento, CA, 95817, USA. Electronic address: iebrown@ucdavis.edu.

PMID: 35871849
DOI: 10.1016/j.amjsurg.2022.07.005

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

MeSH terms

Emergency Service, Hospital*
Hospital Costs
Humans
Incidence
Male
Patient Discharge*
Retrospective Studies