Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, 218539University of California Irvine, Irvine, CA, USA.
Am Surg. 2021 Dec;87(10):1633-1637. doi: 10.1177/00031348211051694. Epub 2021 Oct 21.
Studies show follow-up phone calls decrease readmission rates (RR) in trauma patients and social vulnerabilities may play a role as well. Minimal literature exists comparing RR of trauma patients who required an inpatient stay to those whose treatment was limited to the Emergency Department (ED), as they are at high risk of recidivism. We hypothesized post-trauma follow-up calls would show higher RR for ED patients than those requiring inpatient stay, as well as potentially differing outcomes for minorities.
A retrospective analysis from 2019-2020 of 1328 trauma patients from UCI Medical Center, discharged from inpatient facilities or the ED. A questionnaire script read by a nurse practitioner to patients phone call following discharge. Data associated with readmission were captured. Multivariable logistic regression analysis was performed, controlling for patient factors including severity of injury.
Patients discharged from the ED were 47.4% less likely to be readmitted than those who required an inpatient stay ( < .01). However, ED patients were 88.7% less likely to receive a prescription than inpatient stay patients ( < .01). No difference between ED and inpatient discharge contact rates was noted ( < .99). Furthermore, no difference in readmission rates was noted for minorities.
Post-trauma follow-up calls showed lower RR for index ED visit patients than those requiring inpatient stay, contrary to expectations. However, ED visit patients were also less likely to receive/fill prescriptions compared to those requiring inpatient stay. Ongoing analysis is warranted to further validate and improve follow-up call programs to ensure equitable health care.
研究表明,对创伤患者进行电话随访可降低再入院率(RR),社会脆弱性也可能发挥作用。比较因需要住院治疗和仅在急诊科(ED)接受治疗而导致再入院风险较高的创伤患者的 RR 方面,相关文献极少。我们假设,与需要住院治疗的患者相比,接受创伤后随访电话的 ED 患者的 RR 更高,而且少数民族患者的结局也可能存在差异。
这是一项 2019 年至 2020 年期间对 UCI 医疗中心 1328 例创伤患者的回顾性分析,这些患者从住院病房或 ED 出院。由一名执业护士根据患者的出院情况向患者拨打电话并询问问题。收集与再入院相关的数据。采用多变量逻辑回归分析,控制患者的严重受伤程度等因素。
与需要住院治疗的患者相比,从 ED 出院的患者再入院的可能性低 47.4%(<0.01)。然而,ED 患者获得处方的可能性比住院患者低 88.7%(<0.01)。ED 和住院患者的出院后联系率无差异(<0.99)。此外,少数民族患者的再入院率无差异。
与预期相反,创伤后随访电话显示急诊就诊患者的 RR 低于需要住院治疗的患者。然而,与需要住院治疗的患者相比,ED 就诊患者获得处方的可能性也较低。需要进一步的分析来验证和改进随访电话计划,以确保公平的医疗保健。