Many ER Patients Return Shortly After Their Emergency Visit: Flaw in the Medical System?

Many patients who have recently visited the emergency room (ER) will be heading back within a few days for fear that their symptoms might return, according to a restudy study published in the Annals of Emergency Medicine.

Researchers found that oftentimes, their decision to go back to the hospital stemmed from limited use of outpatient care, including problems assessing care with lack of insurance, dissatisfaction with a primary care physician and general lack of trust in their primary care physician, overall.

"When asked why they did not follow up as an outpatient, patients reported feeling that their symptoms were too severe to wait until their scheduled appointment or being instructed to return to the ER by the outpatient provider they contacted," said lead study author Kristin Rising, MD, of the Department of Emergency Medicine at Thomas Jefferson University in Philadelphia, Penn., in a news release.

For their findings, researchers conducted 60 in-person interviews with patients who returned to the emergency department within nine days of discharge. The primary reason given for returning to the ER was fear or uncertainty of a medical condition that brought them there in the first place. Neither discharge instruction from the original visit nor transportation were cited as particular post-discharge problems; these patients were most likely to be experiencing a deterioration of a chronic or pre-existing condition, such as asthma.

A majority of patients--such as up to 70 percent--had a primary care physician. Yet many often reported seeking follow-up care in an outpatient clinic for health issues.

"The medical community must learn to meet our patients when and where they need us," Dr. Rising concluded. "Sometimes, they may just need reassurance, especially when there is no clear explanation for what is causing their symptoms. Going forward, technology may play a role in facilitating connectedness with care teams to help patients stay healthy."