A National Depiction of Children With Return Visits to the Emergency Department Within 72 Hours, 2001–2007

Abstract

Analysis of the National Hospital Ambulatory Medical Care Survey database offers a national perspective into ED RVs in children. In this era of increasing utilization, these results can help physicians and policy makers address the unique needs of this population and create interventions that will optimize patient service while attempting to control potentially unnecessary RVs.

Unplanned reattendances at the paediatric emergency department within 72 hours: a one-year experience in KKH

“…(2,3,(7)(8)(9) In the paediatric population, parental concern or anxiety may play a significant role. (3,7,10) Higher reattendance rates may, therefore, indicate suboptimal clinical care or failure to address parental concerns at the first visit. Consequently, the incidence of unplanned reattendances is regarded as a quality-of-care indicator that drives the improvement of clinical care and communication delivered at the initial visit.…”

“…Patients returning to the ED within 72 hours of their initial presentation may contribute to overcrowding, (1)(2)(3)(4) which can lead to delayed treatment, patient dissatisfaction, straining of ED resources and increased healthcare costs. (1,2,5,6) Reattendances may be due to illness progression (3,7,8) or parental preference for ED care, (5) but may also reflect failure to appropriately diagnose, treat and communicate follow-up advice at the first visit. (2,3,(7)(8)(9) In the paediatric population, parental concern or anxiety may play a significant role.…”

“…Consequently, the incidence of unplanned reattendances is regarded as a quality-of-care indicator that drives the improvement of clinical care and communication delivered at the initial visit. (3,4,11,12) There is also an increasing focus on admissions for return visits, as high admission rates may represent medical errors such as misdiagnoses or inappropriate treatment. (8) A majority of studies have associated reattendance with young age; higher acuity; attendance during the busiest hours; presence of chronic illness; infectious disease or respiratory diagnoses; and higher rates of admission.…”

“…(1,2,5,6) Reattendances may be due to illness progression (3,7,8) or parental preference for ED care, (5) but may also reflect failure to appropriately diagnose, treat and communicate follow-up advice at the first visit. (2,3,(7)(8)(9) In the paediatric population, parental concern or anxiety may play a significant role. (3,7,10) Higher reattendance rates may, therefore, indicate suboptimal clinical care or failure to address parental concerns at the first visit.…”

Consultas ambulatorias pediátricas atendidas en el Servicio de Urgencia de un hospital universitario

“…Los principales factores de riesgo de hospitalización fueron el período de RN y las consultas por ictericia, síntomas neurológicos e intoxicaciones. Finalmente, la tasa de consultas repetidas fue similar a lo comunicado en otros estudios (3,9% vs 2,7-5,2%) [24][25][26][27][28] ; lo cual puede ser explicado por el perfil sociodemográfico y clínico de los pacientes que consultan en nuestro SU, donde los médicos pediatras citan a control a los pacientes en el SU como alternativa a la hospitalización o a su derivación a los servicios de atención primaria.…”