INJURY RECIDIVISM IN A RURAL ED

Study objective: To determine the degree of injury recidivism in our E D population and to identify indicators of injury recidivism. Methods: We conducted a retrospective review in a university-affiliated depart ment of emergency medicine. The study participants were patients who p resented for treatment of an injury. An injury recidivist was defined as a patient who presented for treatment of two or more unique injurie s during the 1-year study period. The injured population was divided i nto three categories: (1) those with a single injury visit, (2) those with two to three injury visits, and (3) those with four or more injur y visits. Demographics, mechanism of injury, and outcome data were col lected and comparative analyses performed. Results: Of the 37,360 ED p atient visits, 12,075 were injury related. Of the injury visit load, 2 ,838 of the 12,075 (24%) were injury recidivists. Of injured patients, 1,239 of 10,476 (12%) were recidivists. The sex distribution was simi lar among the groups, but the mean age decreased as the degree of reci divism increased. The degree of recidivism was higher for patients wit h Medicaid and far those who were uninsured. Lower mean medical charge s per visit were found with increasing degree of recidivism, but the a verage total charges per patient increased with increasing degree of r ecidivism. Increasing degree of recidivism was associated with decreas ing incidence of transportation-related injury but increased incidence of overexertion or intentional injuries. Conclusion: A small group of patients account for a significant proportion of ED injury visits. In comparison with injury patients seen once during the year, recidivist s represent a younger population of lower socioeconomic status, and th ey are at increased risk of intentional injury.