Adekoya Nelson, Roberts Henry, Truman Benedict I
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Health Serv Res Manag Epidemiol. 2022 Jul 12;9:23333928221111269. doi: 10.1177/23333928221111269. eCollection 2022 Jan-Dec.
To describe characteristics of a nationally representative sample of patient visits that ended with a referral for follow-up medical care after discharge from hospital emergency department (ED) visits.
We used 2018 National Hospital Ambulatory Medical Care Survey data to identify patient characteristics associated with higher rates of visits with referrals for follow-up medical care after ED discharge from nonfederal short-stay and general hospitals throughout the United States. Referral included categories of all disposition variables that indicated referral to a source of care consistent with the patient's clinical condition at ED discharge.
Approximately 97 million of 130 million visits (29 700/100 000 US resident population) were referred for follow-up medical care during 2018. Visit referral rates were higher among females (33 100) than among males (26 300/100 000 population); higher among Black patients (61 700) than among White patients (25 600/100 000 population); highest in the South (33 200/100 000 population); and similar rates in Nonmetropolitan (29 900/100 000 population) and Metropolitan Statistical Areas (30 200/100 000 population). Visit referral rates were higher for patients with Medicaid/Children's Health Insurance Program (CHIP) (66 900) than those with Medicare (31 500) or private insurance (14 000/100 000 population). Abnormal clinical findings and injuries were the discharge diagnoses most often referred for follow-up medical care.
Higher visit referral rates were observed among female sex, non-Hispanic Black race, Medicaid/CHIP, abnormal clinical findings, and injuries. Future studies might reveal reasons that prompted higher referral rates among various patients' characteristics.
描述全国代表性患者就诊样本的特征,这些就诊以出院后从医院急诊科(ED)就诊转介进行后续医疗护理而告终。
我们使用2018年全国医院门诊医疗调查数据,以确定与美国各地非联邦短期住院和综合医院急诊科出院后转介进行后续医疗护理就诊率较高相关的患者特征。转介包括所有处置变量类别,这些变量表明转介到与患者急诊科出院时临床状况相符的护理来源。
2018年期间,1.3亿次就诊中有约9700万次(每10万美国居民人口中有29700次)被转介进行后续医疗护理。女性就诊转介率(每10万人口中有33100次)高于男性(每10万人口中有26300次);黑人患者(每10万人口中有61700次)高于白人患者(每10万人口中有25600次);南部最高(每10万人口中有33200次);非大都市地区(每10万人口中有29900次)和大都市统计区(每10万人口中有30200次)的转介率相似。医疗补助/儿童健康保险计划(CHIP)患者(每10万人口中有66900次)的就诊转介率高于医疗保险患者(每10万人口中有31500次)或私人保险患者(每10万人口中有14000次)。异常临床检查结果和损伤是最常被转介进行后续医疗护理的出院诊断。
在女性、非西班牙裔黑人种族、医疗补助/CHIP、异常临床检查结果和损伤患者中观察到较高的就诊转介率。未来的研究可能会揭示促使不同患者特征转介率较高的原因。