Thirty-day Emergency Department Utilization after Distal Radius Fracture Treatment: Identifying Predictors and Variation

Background:. Unplanned hospital visits are costly and may indicate reduced care quality. In this analysis, we aim to investigate the emergency department (ED) utilization for patients 30 days after treatment for a distal radius fracture (DRF) with an emphasis on DRF-related diagnoses of complication...

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Main Authors: Jacob S. Nasser, BS, Ching-Han Chou, MS, Kevin C. Chung, MD, MS
Format: Article
Language:English
Published: Wolters Kluwer 2019-09-01
Series:Plastic and Reconstructive Surgery, Global Open
Online Access:http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000002416
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author Jacob S. Nasser, BS
Ching-Han Chou, MS
Kevin C. Chung, MD, MS
author_facet Jacob S. Nasser, BS
Ching-Han Chou, MS
Kevin C. Chung, MD, MS
author_sort Jacob S. Nasser, BS
collection DOAJ
description Background:. Unplanned hospital visits are costly and may indicate reduced care quality. In this analysis, we aim to investigate the emergency department (ED) utilization for patients 30 days after treatment for a distal radius fracture (DRF) with an emphasis on DRF-related diagnoses of complications and examine nationwide variation in returns to the ED after treatment. Methods:. In this population-based analysis, we used the Truven MarketScan database to identify adult patients who underwent treatment for their DRF. We examined primary diagnoses upon ED visits to assess for relation to treatment. Multivariable logistic regression was performed to evaluate the risk of DRF-related ED visits and pain-related diagnoses. Results:. Of the patients who underwent treatment for a DRF, 2% of surgical patients and 4% of nonsurgical patients visited the ED within 30 days after treatment with a DRF-related diagnosis. The most common diagnoses for all patients were pain-related diagnoses. Patients receiving internal fixation were less likely to experience a DRF-related visit compared with patients receiving other surgical treatments most likely because of no exposed hardware. In addition, patients receiving surgical in the South were more likely to visit the ED with a pain-related diagnosis compared with any other region. Conclusions:. Policy makers should include ED visits after treatment for outpatient hand conditions as indicators of care quality. Given the geographic differences in the ED utilization for this patient population, collaborative initiatives and institutional-level policy may help reduce variation in care for patients after treatment for their fracture care.
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spelling doaj.art-6441e07f41eb45abbbe41d34895b34892022-12-21T20:12:18ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742019-09-0179e241610.1097/GOX.0000000000002416201909000-00012Thirty-day Emergency Department Utilization after Distal Radius Fracture Treatment: Identifying Predictors and VariationJacob S. Nasser, BS0Ching-Han Chou, MS1Kevin C. Chung, MD, MS2From the *Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, Mich.†Center for Artificial Intelligence in Medicine, Chang-Gung Memorial Hospital, Taoyuan, Taiwan‡Section of Plastic Surgery, Professor of Surgery, Assistant Dean for Faculty Affairs, University of Michigan Medical School, Ann Arbor, Mich.Background:. Unplanned hospital visits are costly and may indicate reduced care quality. In this analysis, we aim to investigate the emergency department (ED) utilization for patients 30 days after treatment for a distal radius fracture (DRF) with an emphasis on DRF-related diagnoses of complications and examine nationwide variation in returns to the ED after treatment. Methods:. In this population-based analysis, we used the Truven MarketScan database to identify adult patients who underwent treatment for their DRF. We examined primary diagnoses upon ED visits to assess for relation to treatment. Multivariable logistic regression was performed to evaluate the risk of DRF-related ED visits and pain-related diagnoses. Results:. Of the patients who underwent treatment for a DRF, 2% of surgical patients and 4% of nonsurgical patients visited the ED within 30 days after treatment with a DRF-related diagnosis. The most common diagnoses for all patients were pain-related diagnoses. Patients receiving internal fixation were less likely to experience a DRF-related visit compared with patients receiving other surgical treatments most likely because of no exposed hardware. In addition, patients receiving surgical in the South were more likely to visit the ED with a pain-related diagnosis compared with any other region. Conclusions:. Policy makers should include ED visits after treatment for outpatient hand conditions as indicators of care quality. Given the geographic differences in the ED utilization for this patient population, collaborative initiatives and institutional-level policy may help reduce variation in care for patients after treatment for their fracture care.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000002416
spellingShingle Jacob S. Nasser, BS
Ching-Han Chou, MS
Kevin C. Chung, MD, MS
Thirty-day Emergency Department Utilization after Distal Radius Fracture Treatment: Identifying Predictors and Variation
Plastic and Reconstructive Surgery, Global Open
title Thirty-day Emergency Department Utilization after Distal Radius Fracture Treatment: Identifying Predictors and Variation
title_full Thirty-day Emergency Department Utilization after Distal Radius Fracture Treatment: Identifying Predictors and Variation
title_fullStr Thirty-day Emergency Department Utilization after Distal Radius Fracture Treatment: Identifying Predictors and Variation
title_full_unstemmed Thirty-day Emergency Department Utilization after Distal Radius Fracture Treatment: Identifying Predictors and Variation
title_short Thirty-day Emergency Department Utilization after Distal Radius Fracture Treatment: Identifying Predictors and Variation
title_sort thirty day emergency department utilization after distal radius fracture treatment identifying predictors and variation
url http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000002416
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