Predictors of Return Visits Among Insured Emergency Department Mental Health and Substance Abuse Patients, 2005-2013

Sangil Lee; Jeph Herrin; William V Bobo; Ryan Johnson; Lindsey R Sangaralingham; Ronna L Campbell

doi:10.5811/westjem.2017.6.33850

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Predictors of Return Visits Among Insured Emergency Department Mental Health and Substance Abuse Patients, 2005-2013

Journal article

Open access

Peer reviewed

Predictors of Return Visits Among Insured Emergency Department Mental Health and Substance Abuse Patients, 2005-2013

Sangil Lee, Jeph Herrin, William V Bobo, Ryan Johnson, Lindsey R Sangaralingham and Ronna L Campbell

The western journal of emergency medicine, Vol.18(5), pp.884-893

08/2017

DOI: 10.5811/westjem.2017.6.33850

PMCID: PMC5576625

PMID: 28874941

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Abstract

Our goal was to describe the pattern and identify risk factors of early-return ED visits or inpatient admissions following an index mental health and substance abuse (MHSA)-related ED visit in the United States. We performed a retrospective cohort study using Optum Labs Data Warehouse, a nationally representative database containing administrative claims data on privately insured and Medicare Advantage enrollees. Authors identified patients presenting to an ED with a primary diagnosis of MHSA between 2005 and 2013 who were discharged home. Study inclusion required continuous insurance enrollment for the 12 months preceding and the 31 days following the index ED visit. During the study period we included only the first ED visit for each patient. A total of 49,672 (14.2%) had a return visit to the ED or had a hospitalization within 30 days following discharge. Mean time to the next ED visit or inpatient admission was 11.7 days. An increased age (age 65+ vs. age <18 years; OR 1.65, 95% CI [1.57 to 1.74]), chronic medical comorbidities (Hwang comorbidity 5+ vs 0; OR 1.31, 95% CI [1.27 to 1.35]), prior ED and inpatient utilization (4+ visits vs 0 visits; OR 5.59, 95% CI [5.41 to 5.78]) were associated with return visits within 30 days following discharge. In an analysis of nearly 350,000 ED visits for MHSA, 14.2 % of patients returned to the ED or hospital within 30 days. This study identified a number of factors associated with return visits for acute care.

Adolescent

Adult

Aged

Databases, Factual

Emergency Service, Hospital - statistics & numerical data

Female

Hospitalization - statistics & numerical data

Humans

Insurance Coverage - statistics & numerical data

Insurance, Health - statistics & numerical data

Male

Mental Disorders - epidemiology

Mental Disorders - therapy

Middle Aged

Patient Discharge - statistics & numerical data

Retrospective Studies

Risk Factors

Substance-Related Disorders - epidemiology

Substance-Related Disorders - therapy

United States - epidemiology

Young Adult

Details

Title: Subtitle: Predictors of Return Visits Among Insured Emergency Department Mental Health and Substance Abuse Patients, 2005-2013
Creators: Sangil Lee - University of Iowa
Jeph Herrin - Yale University
William V Bobo - Mayo Clinic in Florida
Ryan Johnson - Mayo Clinic in Florida
Lindsey R Sangaralingham - Mayo Clinic in Arizona
Ronna L Campbell - Mayo Clinic
Resource Type: Journal article
Publication Details: The western journal of emergency medicine, Vol.18(5), pp.884-893
DOI: 10.5811/westjem.2017.6.33850
PMID: 28874941
PMCID: PMC5576625
NLM abbreviation: West J Emerg Med
ISSN: 1936-900X
eISSN: 1936-9018
Language: English
Date published: 08/2017
Academic Unit: Emergency Medicine; Injury Prevention Research Center
Record Identifier: 9984296979102771

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