The boomerang study: Increased hospital re-admission via the emergency department

Aims This research was performed to assess if a reduced length of hospital stay was associated with increased re-attendances to, and re-admissions from, the Emergency Department (ED). Methods Inpatient discharge and ED attendance records over a ten-year period were sampled and collated. Independent sample t-tests and regression were used to assess changes. Results The analyses found a statistically significant decrease in inpatient hospital length of stay (7.34 to 6.69 days) and a significant increase in ED re-attendance for recently discharged inpatients from 8.88% (539/6065) to 10.98% (687/6255). However, the overall percentage of inpatients returning to a hospital bed within 30 days of discharge did not change significantly from 12.30% (746/6065) to 12.65% (791/6255). Conclusion Results confirm that an increasing percentage of recently discharged inpatients are attending the ED. This finding does not support the hypothesis that increased ED re-attendance of recently discharged inpatients is due to reduced hospital stay because the overall re-admission rate for recently discharged inpatients did not increase. Instead, further analysis revealed a significant change in the re-entry route as the increase in ED attendances is mirrored by a decrease in hospital re-admission via other routes (e.g. outpatient clinics). This change has increased the workload of an already overcrowded ED.