This will be a retrospective study in which the electronic health record (EHR) at AUBMC will be queried for all the variables available on the system 

Hypothesis:

Patients with unscheduled return visits within 72h to the ED between the period of 1 January 2009 and 31 October 2015 represent a high-risk population, require re-admission, are frequent visitors of the ED and have increased mortality in comparison to matched cases for age, gender and visit date.

1.      Characterize the high-risk re-admissions within 72h to the ED.

2.      Determine the proportion of high-risk re-admissions within 72h that:

a.       required admission to the ED within 72h

b.      expired in the ED upon high re-admissions within 72h

c.       that were related to the management of chronic diseases

3.      Investigate the role of patient demographics, ED scheduling and workload, patient clinical parameters and provider type and factors in predicting high-risk re-admissions within 72h.

All patients that visited the ED between 1 November 2014 and 30 November 2015 will be included in the study. All cases that then present as high-risk re-admissions within 72h will be included. Matched controls will be selected from the same ED shift of the case and matched for age, gender and date of visit.

Cases will be selected based on re-admission to the emergency department within 72h of initial visit. Controls will be matched based on age, gender and physician. Controls will be selected from the same ED shift that the case was selected.