Thirty-day Emergency Department Utilization after Distal Radius Fracture Treatment: Identifying Predictors and Variation

Unplanned hospital visits are costly and may indicate reduced care quality. In this analysis, we aim to investigate the emergency department (ED) utilization for patients 30 days after treatment for a distal radius fracture (DRF) with an emphasis on DRF-related diagnoses of complications and examine nationwide variation in returns to the ED after treatment. METHODS: In this population-based analysis, we used the Truven MarketScan database to identify adult patients who underwent treatment for their DRF. We examined primary diagnoses upon ED visits to assess for relation to treatment. Multivariable logistic regression was performed to evaluate the risk of DRF-related ED visits and pain-related diagnoses. RESULTS: Of the patients who underwent treatment for a DRF, 2% of surgical patients and 4% of nonsurgical patients visited the ED within 30 days after treatment with a DRF-related diagnosis. The most common diagnoses for all patients were pain-related diagnoses. Patients receiving internal fixation were less likely to experience a DRF-related visit compared with patients receiving other surgical treatments most likely because of no exposed hardware. In addition, patients receiving surgical in the South were more likely to visit the ED with a pain-related diagnosis compared with any other region. CONCLUSIONS: Policy makers should include ED visits after treatment for outpatient hand conditions as indicators of care quality. Given the geographic differences in the ED utilization for this patient population, collaborative initiatives and institutional-level policy may help reduce variation in care for patients after treatment for their fracture care.