Emergency department arrival times in Florida heart failure patients utilizing Fisher-Rao curve registration: A descriptive population-based study

Background: Emergency room utilization and hospital readmission rates are disproportionately high for heart failure patients (HF). Emergency department (ED) utilization is intimately intertwined with hospital readmissions. Objective: Describe the arrival time distribution of HF patients presenting to the ED. Method: The study analyzed heart failure discharge data from the Florida State Emergency Department Database and the Florida State Inpatient Database from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality. Data were treated as a Poisson process and analyzed using functional data analysis tools. Results: HF arrivals are multi-modal with the largest peak arrival time in the middle of the day as well as a smaller peak in the early morning hours, especially in rural areas. Conclusions: The arrival pattern has minor differences in rural and urban areas. HF clinic appointments should be established in the early morning hours when these patients utilize the ED. (C) 2018 Elsevier Inc. All rights reserved.