262 Rehabilitation Transfers to an Emergency Department

Abstract

Study Objective: The study's purpose is to determine the medical reasons for transfer and the treatment given so that emergency physicians can provide efficient care and physiatrists can improve medical management prior to and during the rehab stay to avoid ED transfers. Methods: A retrospective study of randomly samples of patients one that came to the ED from a referring rehabilitation hospital and a second group who were admitted from the ED hospital for the past 3 years. Variables that were examined were the following: demographics; reason for admission to rehab; medical care received prior to transfer to rehab; length of stay in rehab and medical co-morbidities and complications. The data was then compared using an ANOVA to examine what if any differences there were in the 2 patient populations and what might be the differences in types of care given in the ED. Results: There were a total of 1034 patients in the study with 534 having tranferred out the ED from a rehabilitation hospital and 500 from the ED. There was a significant difference with regards to ethnicity (p. 00), reason for visit (p.00), length of stay (.00), age (p.01), cost of visit, (p.00), level of care, (p.01), length of stay (p.01) and discharge condition (.01). Conclusion: The patients transferred from the rehabilitation hospitals had complex and intense medical and often psychological issues. These patients' medical needs require a high level of resources from the ED. They also leave the hospital in sub optimal conditions indicating they may return to the hospital via the ED prior to completing their treatment within the rehabilitation hospital.