Understanding Emergency Department 72-Hour Revisits Among Medicaid Patients Using Electronic Healthcare Records.

Area of Science:

• Health Informatics
• Public Health
• Healthcare Management

Background:

• Electronic Healthcare Records (EHRs) offer potential for improving healthcare quality and reducing costs.
• Emergency Department (ED) recidivism rates in the Medicaid Program are key performance indicators for hospitals.
• Understanding patterns of ED revisits is crucial for effective healthcare delivery.

Purpose of the Study:

• To analyze characteristics of 72-hour ED return visits among Medicaid patients using EHR data.
• To identify factors contributing to frequent ED revisits within the Medicaid population.
• To inform the development of predictive models for high-risk patients.

Main Methods:

• Analysis of 1,149,738 EHRs from ED Medicaid patients over a 2-year period.
• Statistical L1-logistic regression and random forest analyses were employed.
• Comparison of patient diagnoses and ED usage patterns between frequent and infrequent visitors.

Main Results:

• Frequent flyer patients constitute 47% of all Medicaid ED revisits.
• Frequent ED visitors with recent prior revisits are thrice more likely to be readmitted.
• Distinct patterns in ED usage and diagnoses exist between frequent and infrequent patient groups.

Conclusions:

• Frequent ED revisits among Medicaid patients present a significant challenge.
• Identifying distinct patient profiles can guide targeted interventions to improve care efficacy and ED workflow.
• This research lays the groundwork for predictive models to identify patients at high risk of ED revisits.