Patients pathways before and after treatments in emergency departments: A retrospective analysis of secondary data in Germany.

Increasing emergency department (ED) utilization induces considerable pressure on ED staff and organization in Germany. Reasons for certain ED attendances are seen partly in insufficient continuity of care outside of hospitals. To explore the health care patterns before and after an ED attendance in Germany, we used claims data from nine statutory health insurance funds, covering around 25 % of statutory health insurees (1). We descriptively analyzed ED attendances for adult patients in 2016 according to their sociodemographic characteristics and diagnoses (2). Based on the ED attendance as initial event, we investigated health care provider utilization 180 days before and after the respective ED treatment and are presented by means of Sankey diagrams. In total, 4,757,536 ED cases of 3,164,343 insured individuals were analyzed. Back pain was the most frequent diagnosis in outpatient ED cases (5.0 %), and 80.2 % of the patients visited primary care physicians or specialists 180 days before and 78.8 % 180 days after ED treatment. Among inpatient cases, heart failure (4.6 %) was the leading diagnosis and 74.6 % used primary care physicians or specialists 180 days before and 65.1 % 180 days after ED treatment. The ED re-attendance slightly increased for back pain (4.9 % to 7.9 %) and decreased for heart failure (13.4 % to 12.6 %).

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Déclaration de conflit d'intérêts

Declaration of Competing Interest ll authors report no conflicts of interest regarding the submitted INDEED work. As mentioned in the ICMJE Disclosure form only relationships/activities/interests that are related to the content of your manuscript are to be mentioned. “Related” means any relation with for-profit or not-for-profit third parties whose interests may be affected by the content of the manuscript. We corrected to title page accordingly. INDEED was funded by the Innovation Fund of the Federal Joint Committee (G-BA: Gemeinsamer Bundesausschuss, 01VSF16044). G-BA is the highest decision-making body of the joint self-government of physicians, dentists, hospitals and public health insurance companies in Germany. All authors report no conflicts of interest regarding the submitted INDEED work.