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Am J Emerg Med ; 38(11): 2387-2390, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33041118

RESUMEN

OBJECTIVES: Return visits to the emergency department (ED) and subsequent readmissions are common for patients who are unable to fill their prescriptions. We sought to determine if dispensing medications to patients in an ED was a cost-effective way to decrease return ED visits and hospital admissions for skin and soft tissue infections (SSTIs). METHODS: A retrospective review of ED visits for SSTIs, during the 24 weeks before and after the implementation of a medication dispensing program, was conducted. Charts were analyzed for both ED return visits and hospital admissions within 7 days and 30 days of the initial ED visit. Return visits were further reviewed to determine if the clinical conditions on subsequent visits were related to the initial ED presentation. A cost analysis comparing the cost of treatment to cost savings for return visits was also performed. RESULTS: Before the implementation of the medication dispensing program, the return rate in 7 days for the same condition was 9.1% and the rate of admission was 2.8%. The return rate for the same condition in 8-30 days was 2.1% and the rate of admission was 1.0%. After the implementation of the medication dispensing program, the return rate for the same condition in 7 days was 8.0%, and the admission rate was 1.7%. The return rate for the same condition in 8-30 days was 0.8%, and the admission rate was 0%. The total cost of dispensed medications was $4050, while total cost savings were estimated to be $95,477. CONCLUSION: A medication dispensing program in the ED led to a reduction in return visits and admissions for SSTIs at both 7 days and 30 days. For a cost of only $4050, an estimated total of $95,477 was saved. A medication dispensing program is a cost-effective way to reduce return visits to the ED and subsequent admissions for certain conditions.


Asunto(s)
Antibacterianos/uso terapéutico , Atención a la Salud/métodos , Servicio de Urgencia en Hospital , Hospitalización/estadística & datos numéricos , Readmisión del Paciente/estadística & datos numéricos , Servicios Farmacéuticos , Enfermedades Cutáneas Infecciosas/tratamiento farmacológico , Infecciones de los Tejidos Blandos/tratamiento farmacológico , Absceso/tratamiento farmacológico , Celulitis (Flemón)/tratamiento farmacológico , Cefalexina/uso terapéutico , Clindamicina/uso terapéutico , Ahorro de Costo , Análisis Costo-Beneficio , Costos y Análisis de Costo , Doxiciclina/uso terapéutico , Costos de los Medicamentos , Gastos en Salud , Accesibilidad a los Servicios de Salud , Hospitalización/economía , Humanos , Sistemas de Medicación en Hospital , Readmisión del Paciente/economía , Proyectos Piloto , Transportes , Combinación Trimetoprim y Sulfametoxazol/uso terapéutico
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