Factors associated with emergency department visit within 30 days after discharge.

From PubMed:


Post-discharge care remains a challenge because continuity of care is often interrupted and adverse events frequently occur. Previous studies have focused on early readmission but few have investigated emergency department (ED) visit after discharge.


This retrospective observational study was conducted between April 2011 and March 2012 in a referral center in Taiwan. Patients discharged from the general medical wards during the study period were analyzed and their characteristics, hospital course, and associated factors were collected. An ED visit within 30 days of discharge was the primary outcome while readmission or death at home were secondary outcomes.


There were 799 discharged patients analyzed, including 96 (12 %) with an ED visit of 12.4 days post-discharge and 111 (14 %) with readmissions at 13.3 days post-discharge. Sixty patients were admitted after their ED visit. Underlying chronic illnesses were associated with 72 % of ED visits. By multivariate analysis, Charlson score and the use of naso-gastric tube were independent risk factors for ED visit within 30 days after discharge.


Early ED visit after discharge is as high as 12 %. Patients with chronic illness and those requiring a naso-gastric tube or external biliary drain are at high risk for post-discharge ED visit.

Innovative program reducing frequent ER use

From the News-Press:

A pilot program designed to prevent people from repeatedly using Lee County’s swamped hospital ERs, particularly for non-life-threatening substance abuse and mental health disorders, has successfully reduced usage, a new report finds.

The Extended Community Health Outreach, or ECHO, program gives patients who frequently use ERs help finding housing, access to mental health or substance abuse treatment, and information to better maintain their chronic illnesses, such as diabetes.

Since it began with a handful of patients in 2013, ECHO has resulted in nearly 500 fewer ER visits by these patients and an estimated $320,000 in avoided treatment costs, according to Lee Memorial Health System.

Should hospitals pay property taxes?

From the Daily Herald:

The case of whether a downstate hospital can be exempt from property taxes could have a multimillion dollar impact on suburban hospitals and governments in a dispute that’s been going on for years.

The Illinois Supreme Court this week agreed to hear arguments over a 2012 state law that allows hospitals to apply to be exempt from property taxes if they provide a certain amount of free care or subsidies to individual patients or governments.

The problem for the hospitals: An appellate court ruled this year the law is unconstitutional. After all, the court argued, not all the services provided in a hospital are for charity.

Telemedicine: “Virtual help at hospital can be brain-saver for stroke victims”

From QCOnline:

“Time is brain” when it comes to identifying and treating stroke symptoms, according to Dr. Rochelle Sweis, a neurologist and the director of telestroke at the Loyola University Medical Center.

In January, an InTouch Lite Robot called S.A.M. — short for Save A Memory — began being used by UnityPoint Health-Trinity to connect stroke patients with neurology specialists through Loyola’s Virtual Medicine program to quickly assess patients and begin treatment.

This technology lets Loyola neurologists specializing in stroke treatment visually examine patients in Trinity’s emergency rooms through a two-way video and audio link. This will allow for a rapid response and diagnosis time, which will help save brain tissue, according to Ms. Sweis.

Injured dog walks into Indiana hospital emergency room to get help

From IndyStar:

Workers in the emergency room are used to seeing people walk through the door in need of urgent care.

But they didn’t expect what happened Thursday morning, when a dog walked into the ER at Community Hospital Anderson with a leg injury.

According to Dr. Clay Ludlow and Dr. Thomas Short, the dog came to the emergency room around 5:15 a.m.

“He literally walked straight up like he knew he was coming to the right place,” Short told FOX59.

“We checked him out initially in our emergency department and when our shift ended, (we) took him to the emergency vet,” Ludlow said.

FDA Approves First Implant to Treat Opioid Addiction

From Gizmodo:

The US Food and Drug Administration has approved Probuphine, the first implantable drug for the treatment of opioid dependence. It’s a welcome development at a time when scores of Americans are addicted to painkillers such as OxyContin and Vicodin.

Prior to today’s announcement, Probuphine was only approved as a pill or as a film placed in the mouth until it dissolves. This hi-tech implantable version, which consists of four, one-inch-long rods that are placed under the skin, provides ongoing treatment for six months. Unlike pills or films, these implants can’t get lost, forgotten, or stolen, so the drug can’t be abused or resold on the street. What’s more, patients who are in recovery won’t have to be reminded or even think about taking the medication; the implants do all the work.

State Medicaid agencies limiting opioid prescriptions

From Modern Healthcare:

State Medicaid agencies around the country are limiting how many opioids providers can prescribe in an effort to curb the disproportionate number of beneficiaries who are at risk of overdose and death.

Medicaid beneficiaries are prescribed painkillers at twice the rate of other patients and are at three to six times the risk of opioid overdose, the CMS reports (PDF).

North Carolina, for example, found that while the Medicaid population represented approximately 20% of the overall state population (PDF), it accounted for one-third of drug overdose deaths, the majority of which were caused by prescription opioids.


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