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Study of returns to the ER suggests lack of follow-up care

By Lauren Neergaard

WASHINGTON (AP) – No one wants to make a repeat visit to the emergency room for the same complaint, but new research suggests it’s more common than previously thought and surprisingly, people frequently wind up at a different ER the second time around.

Already some ERs are taking steps to find out why and try to prevent unnecessary returns. A Philadelphia hospital, for example, is beginning to test video calls and other steps to link discharged patients to primary care.

The new research, based on records in six states, suggests patients should be pushy about getting follow-up care so they don’t have to return to crowded emergency departments.

“You need to make sure the next day, you connect the dots,” said study co-author Dr. R. Adams Dudley of the University of California, San Francisco. “You cannot count on the health system to connect the dots.”

It’s also a reminder of how disconnected our health care system is. Chances are, your primary care doctor won’t know you made an ER visit unless you call about what to do next.

And if your second visit was to a different ER, often doctors can’t see your earlier X-rays or other tests and have to repeat them, adding preventable costs. While more hospitals and doctors’ offices are trying to share electronic medical records, it’s still far from common, especially in the fast-paced ER.

“It’s frustrating. We’re open 24 hours a day and we don’t necessarily have access to those records,” said UCSF assistant professor Dr. Reena Duseja, an emergency physician who led the research.

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