Trends in emergency department utilization following common operations in New York State, 2005–2014
ED overutilization is a leading cause of increased healthcare costs and a key target for healthcare reform. ED utilization patterns following common operative procedures are unknown.
Using the SPARCS New York (NY) statewide longitudinal administrative database, a longitudinal analysis on 746,633 patients who underwent cholecystectomy (n = 355,368), appendectomy (n = 142,797) or inguinal hernia repair (n = 248,468) from 2005 to 2014 was performed. ED revisits were identified via unique patient identifiers which allow for patient tracking across hospitals in NY State.
In total, 59,255 (7.9%) patients presented to the ED within 30-days of their operation of which 21,638 (36.5%) were admitted. The aggregated rate of ED utilization and admission from the ED were as follows: cholecystectomy (9.5%, 40%), appendectomy (9.1%, 33.1%), and inguinal hernia repair (5.1%, 26.2%), respectively. A longitudinal analysis demonstrated a relative slowing of the rate of increase in hospital readmissions for cholecystectomy and inguinal hernia repair but no change in the number of ED revisits for inguinal hernia repair.
Nearly 1 in 10 patients undergoing cholecystectomy and appendectomy, and 1 in 20 patients undergoing inguinal hernia repair will present to the ED following surgery. The majority of ED visits do not result in admission, calling their necessity into question. These data suggest possible overutilization of the ED following common operations and support the consideration of ED utilization as a quality indicator.
KeywordsHealthcare costs Emergency Department Utilization Complication Admission
Compliance with ethical standards
Craig S. Brown, Jie Yang, Ziqi Meng, James Henderson, Justin B. Dimick, and Dana A. Telem have no conflicts of interest or financial ties to disclose.
- 3.Nawar EW, Niska RW, Xu J (2007) National Hospital Ambulatory Medical Care Survey: 2005 emergency department summary. Adv Data 358:1–32Google Scholar
- 4.Rui P, Kang KAM (2013) National Hospital Ambulatory Medical Care Survey: 2013 Emergency Department Summary Tables. CDCGoogle Scholar
- 5.Oster A, Bindman AB (2003) Emergency department visits for ambulatory care sensitive conditions: insights into preventable hospitalizations. Med Care 41:198–207Google Scholar
- 17.Weiss AJ, Elixhauser A (2006) Trends in operating room procedures in U.S. Hospitals, 2001–2011: Statistical Brief #171. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs, RockvilleGoogle Scholar
- 18.Hall MJ, Schwartzman A, Zhang J, Liu X (2017) Ambulatory surgery data from hospitals and Ambulatory Surgery Centers: United States, 2010. Natl Health Stat Rep 102:1–15Google Scholar