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ER revisits pricey, occur more often than previously reported

Embargoed news from Annals of Internal Medicine

American College of Physicians

1. The high cost of health care: Emergency department revisits are expensive and occur twice as often as previously reported

Free abstract:

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One in five patients return to the emergency department (ED) within 30 days of an initial visit and one in 12 returns after three days, according to an article published in Annals of Internal Medicine. These rates are more frequent than previously reported and place a significant strain on overburdened EDs and the broader health care system.

Little is known about what happens to patients after they are discharged from the ED. Researchers reviewed Healthcare Cost and Utilization Project databases for six states to determine ED revisit rates, variation in revisit rates by diagnosis and state, and associated costs. The researchers found that across all six states, revisit rates were nearly twice as high as previously reported. Only about half of all ED revisits involved a return to the index ED followed by a second discharge home. They also found that total cost of revisits was higher than the total cost of all initial visits. It is not known why ED revisit rates are so high. The authors suggest that understanding what leads to a revisit could help to improve care and lower costs.

Note: For an embargoed PDF, please contact Angela Collom at For an interview with the lead author, please contact Elizabeth Fernandez at or 415-514-1592.

2. New from Annals Graphic Medicine: Mr. S Changes Doctors

Free abstract:

URL goes live when embargo lifts

A patient gets a new physician and a surprising diagnosis in the latest issue of Annals Graphic Medicine. Annals Graphic Medicine uses original graphic narratives, comics, animation, and other creative forms to address medically-relevant topics. All of the content is created by those who provide or receive healthcare. Stories may be poignant, thought-provoking, or just plain entertaining. Below is a clip from the latest story:

Previously, Annals tackled the topic of patient safety with the graphic novel, Missed It. More recently, Annals Graphic Medicine touched on appropriate use of CPR in Betty P., and how love and compassion can help patients heal in 50 Shades of Gray Matter (video).

Note: For an embargoed PDF or to speak with someone from Annals about Annals Graphic Medicine, please contact Angela Collom at


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