Follow-up trends after emergency department discharge for acutely symptomatic hernias: A southwestern surgical congress multi-center trial

The objective of this multi-center study was to examine the follow-up trends after emergency department (ED) discharge in a large and socioeconomically diverse patient population. We performed a 3-year retrospective analysis of adult patients with acutely symptomatic hernias who were discharged from the EDs of five geographically diverse hospitals. Of 674 patients, 288 (43%) were evaluated in the clinic after discharge from the ED and 253 (37%) underwent repair. Follow-up was highest among those with insurance. A total of 119 patients (18%) returned to the ED for hernia-related complaints, of which 25 (21%) underwent urgent intervention. The plan of care for patients with acutely symptomatic hernias discharged from the ED depends on outpatient follow-up, but more than 50% of patients are lost to follow-up, and nearly 1 in 5 return to the ED. The uninsured are at particularly high risk. •43% of patients in the ED with an acutely symptomatic hernia received clinic follow-up.•The uninsured had a significantly lower rate of clinic follow-up and a higher rate of emergent surgery.•The strongest predictors of receiving surgery were clinic visit, caucasian race, incarceration, and inguinal hernia type.•20% of patients returned to the ED after initial discharge and those with private insurance had the lowest rate of return.•After stratifying by insurance status, disparities in outcomes in race and gender persisted.