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Do you ever tell your patients to “follow up with your primary care physician in 3-5 days”? How many of them actually do it? And does it make a difference?
Study Overview:
This study is a retrospective analysis of 28,085 adults (?20 years) presenting with acute abdominal pain (AAP) at 15 German emergency departments (EDs) in 2016.
Key Findings:
Hospitalization rate:
39.8% were admitted to the hospital from the ED.
Outpatient Care (OC) Before ED Visit:
33.9% had an OC visit within 3 days before their ED visit.
Of these, 48.6% were hospitalized.
Outpatient Care After ED Visit:
62.7% had OC follow-up within 30 days.
Factors Increasing Hospitalization Odds:
Age ?65 years: aOR 3.05
Prior OC: aOR 1.71
Male sex: aOR 1.44
In-Hospital Mortality:
3.1%
ED Re-visits Within 30 Days:
More likely in age ?65: aOR 1.32
Less likely with prior OC: aOR 0.37
Conclusion:
Acute abdominal pain in the ED is associated with high hospitalization and mortality rates, especially in older adults and those with prior outpatient visits. Prior outpatient contact is linked with both increased admission likelihood and reduced risk of ED re-visits, highlighting its complex role in care continuity. Improving outpatient care access and coordination may reduce ED burden and enhance outcomes for AAP patients.
While there are other factors to consider ie the health care system and its infrastructure, this does provide some interesting food for thought about what happens when we discharge patients.
References
Verleger K, Fischer-Rosinsky A, Möckel M, et al. Health care utilization of patients with acute abdominal pain before and after emergency department visits. Scand J Trauma Resusc Emerg Med. 2024;32(1):68. Published 2024 Aug 12. doi:10.1186/s13049-024-01237-7