First large-scale study to examine factors associated with recurrent emergency department visits for skin and soft tissue infections

December 20, 2016

More than 16 percent of all emergency department visits for skin and soft tissue infections (SSTIs) were for a recurrent infection

A study from CDDEP researchers and collaborators finds an association between recurrent emergency department (ED) visits for skin and soft tissue infections (SSTI), sociodemographic factors and comorbidities, using California emergency department discharge data from 2005 to 2011.

This is the first large-scale study to examine factors associated with recurrent ED visits. The findings, based on nearly 200,000 ED visits, indicate:

  • More than 16 percent of all ED visits for an SSTI were for a recurrent infection within six months following an initial SSTI.
  • Patients with a history of alcohol abuse, drug abuse, or liver disease were 35 percent more likely to have a recurrent SSTI visit than those without these conditions. Obese patients were 30 percent more likely to have a recurrent SSTI visit than non-obese patients.
  • The most significant associations among sociodemographic factors were patients’ insurance status. Medicare coverage or self-pay status were associated with slightly higher odds of a recurrent visit, while patients with Medicaid were 33 percent less likely to have a recurrent visit.
  • Patients between the ages of 18 and 44 were 36 percent more likely to have recurrent visits compared to patients under age 18. Those over 64 years were 22 percent less likely to have recurrent visits compared to patients under age 18.

Of the estimated 34.8 million outpatient visits for SSTIs nationally between 2005 and 2011, about one- third were seen in the emergency department. Not everyone with a recurrent infection is treated in the emergency department—some patients likely seek treatment in outpatient clinics or doctors offices—so this does not reflect the entirety of the problem of recurring SSTIs.

According to CDDEP Fellow Dr. Eili Klein, “Recurring skin and soft tissue infections are relatively common, but the factors associated with their recurrence are under-researched. Identification of groups at high risk for repeat SSTIs will be necessary to develop future emergency department-based interventions.”

The study is published in Epidemiology & Infection, available here: www.cambridge.org/core/journals/epidemiology-and-infection/article/div-classtitleincidence-and-factors-associated-with-emergency-department-visits-for-recurrent-skin-and-soft-tissue-infections-%20in-patients-in-california-20052011div/53D2BA0B42BD5C706923CEAB6FC64759 

Study authors: L. May, E. Y. Klein, E. M. Martinez, N. Mojíca, and L. G. Miller

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About the Center for Disease Dynamics, Economics & Policy

The Center for Disease Dynamics, Economics & Policy (CDDEP) produces independent, multidisciplinary research to advance the health and wellbeing of human populations around the world. CDDEP projects are global in scope, spanning Africa, Asia, and North America and include scientific studies and policy engagement. The CDDEP team is experienced in addressing country-specific and regional issues, as well as the local and global aspects of global challenges, such as antibiotic resistance and pandemic influenza. CDDEP research is notable for innovative approaches to design and analysis, which are shared widely through publications, presentations and web-based programs. CDDEP has offices in Washington, D.C. and New Delhi and relies on a distinguished team of scientists, public health experts and economists.

 

Date: 

20 Dec 2016