Nonspecific chest pain and hospital revisits within 7 days of care: variation across emergency department, observation and inpatient visits

Table 1 Nonspecific Chest Pain Index Visit Characteristics, by Type of Index Visit, 2013 and 2014

Characteristic	Type of Index Visit
Characteristic	ED	Observation	Inpatient
Total, N	638,302	325,770	41,794
Originated in the ED	638,302	313,000	37,363
Direct admission	N/A	12,770	4431
Female, %	57.8	57.0	52.8
Age, years, mean	46.6	57.9	60.0
Expected primary payer, %
Medicare	23.7	38.7	47.3
Medicaid	17.1	10.7	10.3
Private	36.3	35.3	27.5
Self-pay / No charge	18.8	11.5	10.5
Other	3.9	3.5	4.2
Patient’s income quartile, %
Quartile 1 (poorest)	35.5	34.6	35.9
Quartiles 2 and 3	49.5	47.7	48.8
Quartile 4 (wealthiest)	13.6	16.2	13.7
Location of residence, %
Large metropolitan	37.7	42.7	42.4
Small metropolitan	39.6	34.6	36.2
Micropolitan	12.7	12.6	12.7
Rural	9.8	9.9	8.5
Diagnoses reported on the index visit, mean N	3.9	8.3	10.4
Most frequent coexisting condition, %^a
Elixhauser Comorbidities^b
Alcohol abuse	1.4	2.7	4.7
Chronic pulmonary disease	8.8	16.8	21.6
Congestive heart failure	2.5	5.9	12.0
Deficiency anemias	1.4	5.6	11.0
Depression	3.2	10.7	13.0
Diabetes	10.7	25.5	33.1
Drug abuse	1.9	2.9	4.4
Fluid/electrolyte disorders	2.3	9.6	15.5
Hypertension	29.9	65.6	75.6
Hypothyroidism	2.4	10.3	12.2
Obesity	2.2	14.6	19.9
Other neurological disorders	1.7	4.4	6.3
Psychoses	1.6	3.4	4.7
Renal failure	1.5	5.3	12.4
Related to heart disease
Other ischemic heart disease^c	6.3	24.4	41.2
Prior AMI	3.4	8.5	13.7
Revisits, N	62,629	20,472	3591

Abbreviations: AMI Acute myocardial infarction, ED Emergency department, N Number, N/A Not applicable
Note: Percentages may not sum to 100% because some index visits are missing the information
^aCoexisting conditions include those from the Elixhauser comorbidity software and those related to heart disease. Only conditions with at least 1% of records in all three settings are shown. The diabetes measure includes diabetes with and without complications
^bThe following indicators were defined using the Elixhauser Comorbidity Software, the specifications of which can be found at https://www.hcup-us.ahrq.gov/toolssoftware/comorbidity/comorbidity.jsp
^cDefined using the ICD-9 CM code 414, Other forms of chronic ischemic heart disease
Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, State Inpatient Databases, State Emergency Department Databases, and State Ambulatory Surgery and Services Databases, 10 states (Georgia, Iowa, Maryland, Nebraska, Nevada, South Carolina, South Dakota, Tennessee, Vermont, Wisconsin), 2013 and 2014

ISSN: 1472-6963