Factors Influencing Early Readmission after Discharge against Medical Advice from the Emergency Department
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Data Collection and Procedure
2.3. Ethical Consideration
2.4. Measurements
2.5. Statistical Analysis
3. Results
3.1. General Characteristics
3.2. Emergency Medical Service Characteristics
3.3. Factors Influencing Readmission within 48 h after DAMA
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Total (n = 5445) | Readmission within 48 h | χ² or t (p) | |
---|---|---|---|---|
Yes (n = 351) | No (n = 5094) | |||
n (%) | n (%) | n (%) | ||
Age (years), M ± SD | 43.52 ± 22.12 | 44.42 ± 24.25 | 43.46 ± 21.96 | −0.73 (0.467) |
0–10 | 563 (10.3) | 50 (14.2) | 513 (10.1) | |
11–20 | 294 (5.4) | 11 (3.1) | 283 (5.6) | |
21–30 | 603 (11.1) | 26 (7.4) | 577 (11.3) | |
31–40 | 786 (14.4) | 46 (13.1) | 740 (14.5) | |
41–50 | 978 (18.0) | 54 (15.4) | 924 (18.1) | |
51–60 | 1024 (18.8) | 75 (21.4) | 949 (18.6) | |
61–70 | 576 (10.6) | 46 (13.1) | 530 (10.4) | |
71–80 | 407 (7.5) | 26 (7.4) | 381 (7.5) | |
≥81 | 214 (3.9) | 17 (4.8) | 197 (3.9) | |
Gender | 0.003 (0.957) | |||
Male | 3141 (57.7) | 202 (57.5) | 2939 (57.7) | |
Female | 2304 (42.3) | 149 (42.5) | 2155 (42.3) | |
Insurance type | 26.23 (< 0.001) | |||
National health insurance | 4496 (82.6) | 275 (78.3) | 4221 (82.9) | |
Medical aid | 444 (8.2) | 49 (14.0) | 395 (7.8) | |
Employee insurance | 113 (2.1) | 7 (2.0) | 106 (2.1) | |
Private insurance | 168 (3.1) | 6 (1.7) | 162 (3.2) | |
Automobile insurance | 142 (2.6) | 4 (1.1) | 138 (2.7) | |
Foreign worker insurance | 82 (1.5) | 10 (2.8) | 72 (1.4) |
Variables | Total (n = 5445) | Readmission within 48 h | χ² or t (p) | |
---|---|---|---|---|
Yes (n = 351) | No (n = 5094) | |||
n (%) | n (%) | n (%) | ||
Type of transportation to the ED | 12.64 (0.005) | |||
Ambulance | 1959 (36.0) | 99 (28.2) | 1860 (36.5) | |
Self-transport | 3391 (62.3) | 249 (71.0) | 3142 (61.6) | |
Inter-facility transfer | 95 (1.7) | 3 (0.9) | 92 (1.8) | |
Length of stay in the ED (h), M ± SD | 5.52 ± 6.34 | 5.56 ± 5.30 | 5.52 ± 6.40 | −0.12 (0.903) |
Korea Informative Classification of Diseases | 43.70 (<0.001) | |||
Infectious diseases | 58 (1.1) | 5 (1.4) | 53 (1.0) | |
Neoplasms | 94 (1.7) | 13 (3.7) | 81 (1.6) | |
Hematology, endocrine system | 113 (2.1) | 8 (2.3) | 105 (2.1) | |
Mental and behavioral disorders | 396 (7.3) | 25 (7.1) | 371 (7.3) | |
Nervous system | 115 (2.1) | 8 (2.3) | 107 (2.1) | |
Eye and adnexa | 43 (0.8) | 1 (0.3) | 42 (0.8) | |
Circulatory system | 147 (2.7) | 18 (5.1) | 129 (2.5) | |
Respiratory system | 116 (2.1) | 8 (2.3) | 108 (2.1) | |
Digestive system | 265 (4.9) | 22 (6.3) | 243 (4.8) | |
Skin and musculoskeletal system | 141 (2.6) | 12 (3.4) | 129 (2.5) | |
Genitourinary system, pregnancy, congenital malformations | 88 (1.6) | 12 (3.4) | 76 (1.5) | |
Abnormal laboratory findings | 1864 (34.2) | 131 (37.3) | 1733 (34.0) | |
Injury, poisoning, and certain other consequences of external causes | 2005 (36.8) | 88 (25.1) | 1917 (37.6) |
Reason | N | (%) |
---|---|---|
Want additional treatment at other hospitals | 1781 | 32.7 |
Economic burden for treatment and evaluation | 1497 | 27.5 |
Want to observe progress at home | 915 | 9.2 |
Lack of awareness of the patient’s severity | 414 | 7.6 |
Distrust of the health providers | 337 | 6.2 |
Variable | OR | 95% Cl | p-Value |
---|---|---|---|
Age | 1.00 | 0.95–1.01 | 0.964 |
Gender Female (REF: Male) | 1.02 | 0.82–1.28 | 0.866 |
Medical insurance status (REF: National health insurance) | |||
Medical aid | 2.02 | 1.46–2.83 | <0.001 |
The employee insured | 1.38 | 0.62–3.08 | 0.429 |
Private insurance | 0.83 | 0.36–1.93 | 0.672 |
Automobile insurance | 0.69 | 0.25–1.92 | 0.480 |
Foreign worker insurance | 2.07 | 1.04–4.09 | 0.037 |
Type of transportation to ED (REF: Ambulance) | |||
Self-transport | 1.41 | 1.08–1.82 | 0.010 |
Inter-facility transfer | 0.56 | 0.17–1.81 | 0.332 |
Length of stay in the ED (hour) | 1.00 | 0.99–1.00 | 0.867 |
Korea Informative Classification of Diseases (REF: Infectious diseases) | |||
Neoplasms | 1.67 | 0.56–5.03 | 0.359 |
Hematology, endocrine system | 0.79 | 0.24–2.57 | 0.696 |
Mental and behavioral disorders | 0.76 | 0.28–2.09 | 0.591 |
Nervous system | 0.82 | 0.25–2.63 | 0.732 |
Eye and adnexa | 0.22 | 0.02–1.92 | 0.169 |
Circulatory system | 1.41 | 0.49–4.06 | 0.529 |
Respiratory system | 0.74 | 0.23–2.34 | 0.621 |
Digestive system | 0.90 | 0.32–2.50 | 0.838 |
Skin and musculoskeletal system | 0.93 | 0.31–2.80 | 0.898 |
Genitourinary system, pregnancy, congenital malformations | 1.68 | 0.55–5.08 | 0.361 |
Abnormal clinical and laboratory findings | 0.81 | 0.32–2.07 | 0.657 |
Injury, poisoning, and certain other consequences of external causes | 0.54 | 0.21–1.40 | 0.200 |
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Moon, B.-K.; Ahn, R.; Min, D.; Shim, J. Factors Influencing Early Readmission after Discharge against Medical Advice from the Emergency Department. Healthcare 2021, 9, 986. https://doi.org/10.3390/healthcare9080986
Moon B-K, Ahn R, Min D, Shim J. Factors Influencing Early Readmission after Discharge against Medical Advice from the Emergency Department. Healthcare. 2021; 9(8):986. https://doi.org/10.3390/healthcare9080986
Chicago/Turabian StyleMoon, Byeong-Keon, Ryeok Ahn, Deulle Min, and JaeLan Shim. 2021. "Factors Influencing Early Readmission after Discharge against Medical Advice from the Emergency Department" Healthcare 9, no. 8: 986. https://doi.org/10.3390/healthcare9080986