Retrospective Cohort Study of Rates of Return ED Visits Among Patients Transported Home by Ambulance

• Main Author: Munjal, Kevin G
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01.01.2016
• Subjects: Epidemiology; Health care management; Medicine
• ISBN: 1369508867; 9781369508864

Emergency Medical Services (EMS) is an important community based healthcare resource that already interacts with many of our most vulnerable patients during transport to the home following hospital discharge. These clinical providers may be appropriately situated to contribute to the transition of care to the home environment. This retrospective cohort study examined utilization patterns of patients over the age of 65 between January and March of 2012 following hospital discharge to test the hypothesis that patients transported home by ambulance experience higher rates of return ED visits and readmission rates compared to a similar cohort transported home by other means. There were 207 patients aged 65 and over found to have been transported home by ambulance between January and March of 2012. Matched controls were found for 162 patients. Compared to the matched controls, the group transported by ambulance experienced a statistically significant higher rate of ED return within 30 days (18.519% vs. 10.494%; OR 1.939; p=0.043). The exposed group also experienced a higher rate of return ED visits within 72 hours (2.469% vs. 0.617%; OR 4.076) and a higher rate of readmission within 30 days (12.346% vs. 6.173%; OR 2.141) though the results did not reach statistical significance. These findings suggests that a patient being transported home by ambulance could be predictive of a high risk of recidivism independent of risk factors commonly used to predict readmission risk. Programs that expand the roles of EMS providers to include simple post-transport interventions conducted by EMTs may be worthy of further exploration.