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

Goh, Guan Lin; Huang, Peiqi; Kong, Man Ching Patrick; Chew, Sing Yian; Ganapathy, Sashikumar

doi:10.11622/smedj.2016105

Cited by 21 publications

(36 citation statements)

References 47 publications

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“…In the KASCH-RD center, respiratory conditions were found to be the most frequent cause of initial ED visits. This is in agreement with Goh et al, where it reported that respiratory conditions were linked with higher ED utilization [ 10 ]. Focusing on ED revisits related to respiratory diseases may reduce ED revisit rates by identifying non-urgent ED visits.…”

Section: Discussionsupporting

confidence: 93%

“…A rather high ED revisit rate (11%) was observed among children with chronic diseases in Saudi Arabia as compared to the general global children’s population : USA 2.7% [ 9 ], Singapore 4.3% [ 10 ], Canada 4.4% [ 11 ], and Taiwan 6.47% [ 12 ]. It may not be possible to compare this study’s findings with these studies, as in our study we calculated the rate of ED revisit in a definitive group, specifically children with chronic diseases.…”

Section: Discussionmentioning

confidence: 99%

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Emergency department 72-hour revisits among children with chronic diseases: a Saudi Arabian study

et al. 2018

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BackgroundEmergency Department (ED) revisits have often been used as an indicator of medical care quality. This study aimed to quantify the frequency of ED revisits within 72 h of discharge and identify its factors among children with chronic diseases.MethodsWe designed a retrospective cohort study of children with at least one chronic disease who were also under 18 years of age and had attended and were discharged from the ED at King Abdullah Specialist Children’s Hospital (KASCH-RD), Riyadh, Saudi Arabia between April 19, 2015 and July 29, 2017. The outcome measure was the frequency of ED revisits during a period of 72 h after discharge.ResultsThe study included 11,057 ED discharges of children with at least one chronic disease. Their revisit rate was 1211 (11%), with 83 (6.9%) having had a second ED revisit within 72 h of ED discharge. According to ICD-10 codes, the most common causes of ED revisits were respiratory, digestive, genitourinary, symptoms, and external causes. Factors of frequent ED revisits within 72 h were young age, institutional health insurance coverage, year of new health information system (2015), external causes, and genitourinary.ConclusionThe rate of 72-h ED revisits after discharge of children with chronic diseases treated at KASCH-RD was relatively high, and was associated with young age, institutional health insurance coverage, year of a new health information system implementation, and external causes of ED visit. These study findings amplify the need for intervention to reduce the rate of early ED revisits among children with chronic diseases.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Emergency department 72-hour revisits among children with chronic diseases: a Saudi Arabian study

et al. 2018

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“…4,5 The rate of hospitalization of 15.8%, however, was lower as compared with reported rate of 17% to 42%. 6,15 Several findings from our study may account for these contrasting results. Repeated URVs did not lead to additional laboratory or radiologic investigations.…”

Section: Discussioncontrasting

confidence: 58%

Unplanned Return Visits to a Pediatric Emergency Department

Furrer¹,

Staubli²,

Albisetti

2019

Pediatr Emer Care

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OBJECTIVES: Unplanned return visits (URVs) to emergency departments (EDs) account internationally for 2.5% to 5.2% of all consultations. ED crowding is an increasing challenge, and URVs seem to contribute to this problem. This study aimed to assess factors for URVs at the ED of a tertiary children's hospital to analyze if they are jointly responsible for the steadily rising amount of treated patients. METHODS: All patients with an URV to a pediatric ED in Switzerland between January and December 2013 were included in the study. Data were taken retrospectively from the electronic patient files, and different variables were defined and analyzed. RESULTS: URVs occurred at an incidence of 4.6%, and mostly concerned infants and toddlers (46%). URVs were independent of weekdays and mostly occurred between 10 AM and 10 PM. In 84.2% of the cases, the URVs were judged as unnecessary, and in 15.8%, a hospitalization was indicated, mainly for children with a worsening respiratory illness. CONCLUSIONS: The occurrence of URVs in our ED was within the incidence reported in the literature. While URVs lead to hospitalization in some patients, the majority of URVs were unnecessary from a medical point of view. These results indicate that a correct evaluation of the child's health state by parents is often challenging and requires repeated medical attendance following a first ED visit, especially in infants with airway diseases and infections. Intensive counseling and scheduled short-term follow-up consultation at the pediatrician's office could prevent URVs to the ED.Objectives: Unplanned return visits (URVs) to emergency departments (EDs) account internationally for 2.5% to 5.2% of all consultations. ED crowding is an increasing challenge, and URVs seem to contribute to this problem. This study aimed to assess factors for URVs at the ED of a tertiary children's hospital to analyze if they are jointly responsible for the steadily rising amount of treated patients.Methods: All patients with an URV to a pediatric ED in Switzerland between January and December 2013 were included in the study. Data were taken retrospectively from the electronic patient files, and different variables were defined and analyzed.Results: URVs occurred at an incidence of 4.6%, and mostly concerned infants and toddlers (46%). URVs were independent of weekdays and mostly occurred between 10 AM and 10 PM. In 84.2% of the cases, the URVs were judged as unnecessary, and in 15.8%, a hospitalization was indicated, mainly for children with a worsening respiratory illness. Conclusions:The occurrence of URVs in our ED was within the incidence reported in the literature. While URVs lead to hospitalization in some patients, the majority of URVs were unnecessary from a medical point of view. These results indicate that a correct evaluation of the child's health state by parents is often challenging and requires repeated medical attendance following a first ED visit, especially in infants with airway diseases and infections. Intensive counseling and scheduled short-ter...

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“…The ED revisit within 72 hours has been widely reported in earlier studies, and its rate depends on the chronic disease status and the cultural background. 6 – 12 The rates of 72-hour ED revisits may depend on age, 10 , 11 gender, 10 , 13 disease categories, 6 – 8 , 12 medical errors, 7 , 8 patients, 7 and doctors. 7 Although data regarding ED revisits within 72 hours can be used to implement changes and modifications to improve the electronic medical record database, the rate of revisits to the ED within 72 hours has not been documented among adults with chronic diseases in Saudi Arabia, particularly in our center.…”

Section: Introductionmentioning

confidence: 99%

Seventy-two-hour emergency department revisits among adults with chronic diseases: a Saudi Arabian study

Ahmed

AlBuraikan

Almazroa

et al. 2018

TCRM

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BackgroundDespite the increase in adult emergency department (ED) utilization in Saudi Arabia, no studies have evaluated the 72-hour revisits. This study estimates the rate of 72-hour ED revisits and identifies its reasons and predictive factors among adults with chronic diseases.Patients and methodsA hospital-based retrospective study that included 24,206 ED discharges for adults with chronic diseases at the adult ED of King Abdulaziz Medical City, Riyadh between September 13, 2015 and July 29, 2017 was performed. We extracted data on demographic information, reasons for ED visits/revisits, health insurance coverage, weekend ED arrival, and mortality.ResultsA sample of 24,206 ED discharges for 19,697 adults with at least one chronic disease was included in the analysis. The rate of 72-hour revisits in this study population was high: 3,144/24,206 (13%) had the first revisit and 319/3,144 (10.1%) had the second ED revisit within 72 hours. Diseases of the circulatory (19%) and genitourinary (15.8%) systems were the major reasons for the first ED revisit. The adjusted relative rate (aRR) of 72-hour ED revisits was higher in adults with chronic diseases and aged ≥60 years (aRR=1.360, 95% CI: 1.41–1.83; P=0.001), patients of female gender (aRR=1.24, 95% CI: 1.09–1.41; P=0.001), patients with health insurance coverage (aRR=4.23, 95% CI: 2.60–6.90; P=0.001), patients arriving to ED on a weekend (aRR=2.13, 95% CI: 1.03–4.41; P=0.041), and new patients (aRR=1.47, 95% CI: 1.25–1.73; P=0.001).ConclusionThe rate of 72-hour revisits is high among adults with chronic diseases. Advancing age, female gender, health insurance coverage, weekend ED arrival, and new patients are the important predictive factors of the high rate of 72-hour revisits. Continuous quality assessment and monitoring of factors related to patients are needed to reduce the frequency of early ED revisits after discharge.

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

Cited by 21 publications

References 47 publications

Emergency department 72-hour revisits among children with chronic diseases: a Saudi Arabian study

Emergency department 72-hour revisits among children with chronic diseases: a Saudi Arabian study

Unplanned Return Visits to a Pediatric Emergency Department

Seventy-two-hour emergency department revisits among adults with chronic diseases: a Saudi Arabian study

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