Potentially avoidable emergency department use by patients discharged to skilled nursing facilities

Author:

Tian Ye1ORCID,Ayyappan Vinay2,Hemmert Keith3,Myers Jennifer3,Gitelman Yevgeniy3,Ryskina Kira3

Affiliation:

1. Penn Presbyterian Medical Center Philadelphia Pennsylvania USA

2. University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA

3. Hospital of University of Pennsylvania Philadelphia Pennsylvania USA

Abstract

AbstractOne‐third of patients discharged from hospitals to skilled nursing facilities (SNF) are sent back to the Emergency Department (ED) within 30 days. Little is known about those patients who are discharged from the ED directly back to SNF. We considered these ED visits as potentially avoidable since they did not result in observation or hospitalization stay. Using a retrospective chart review of 1010 patients with ED visits within 14‐days of discharge to SNF from University of Pennsylvania health system (UPHS) in 2020–2021, we identified 202 patients with potentially avoidable ED visits among medical and surgical patients. The most common reasons for these ED visits were mechanical falls (17.3%), postoperative problems (16.8%), and cardiac or pulmonary complaints (11.4%). Future interventions to decrease avoidable ED visits from SNFs should aim to provide access for SNF patients to receive timely outpatient lab and imaging services and postoperative follow‐ups.

Funder

National Institute on Aging

Publisher

Wiley

Subject

Assessment and Diagnosis,Care Planning,Health Policy,Fundamentals and skills,General Medicine,Leadership and Management

Reference9 articles.

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3. Where Skilled Nursing Facility Residents Get Acute Care: Is the Emergency Department the Medical Home?

4. Nursing home compare claims‐based quality measure technical specifications April 2019.https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/Downloads/Nursing-Home-Compare-Claims-based-Measures-Technical-Specifications-April-2019.pdf

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