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Am J Emerg Med ; 38(11): 2387-2390, 2020 11.
Article in English | MEDLINE | ID: mdl-33041118

ABSTRACT

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.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Delivery of Health Care/methods , Emergency Service, Hospital , Hospitalization/statistics & numerical data , Patient Readmission/statistics & numerical data , Pharmaceutical Services , Skin Diseases, Infectious/drug therapy , Soft Tissue Infections/drug therapy , Abscess/drug therapy , Cellulitis/drug therapy , Cephalexin/therapeutic use , Clindamycin/therapeutic use , Cost Savings , Cost-Benefit Analysis , Costs and Cost Analysis , Doxycycline/therapeutic use , Drug Costs , Health Expenditures , Health Services Accessibility , Hospitalization/economics , Humans , Medication Systems, Hospital , Patient Readmission/economics , Pilot Projects , Transportation , Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use
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