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. 2022 Aug;34(4):584-589.
doi: 10.1111/1742-6723.13961. Epub 2022 Mar 23.

Return visits to the paediatric emergency department

William Hollaway  1 , Meredith L Borland  1   2
Affiliations

Return visits to the paediatric emergency department

William Hollaway et al. Emerg Med Australas. 2022 Aug.

Abstract

Objective: To determine the rate of unplanned return visits (uRVs) within 48 h to a paediatric ED over a 12-month period and describe the factors associated with these uRV.

Methods: Retrospective review of electronic data regarding the initial and follow-up visit at a tertiary paediatric hospital ED in Western Australia. The primary outcome was the number of patients who presented for uRV within 48 h of their initial ED visit.

Results: Between August 2018 and July 2019, 2322 patients returned to the ED for a uRV comprising 3.4% of 68 352 ED presentations with more than 53% returning with infectious causes. Triage category 3 patients were most likely to represent (OR 1.11, P = 0.029) with 3-month to 1-year old (OR 1.37, P < 0.00001) and 1-5-year old (OR 1.32, P < 0.00001) the commonest age groups. There was seasonal variation in uRVs demonstrating a greater number in the winter months. The percentage of uRVs to overall ED presentations was greater in the summer months (3.8-4.1%). There was a significant increase in uRVs occurring up to 2 weeks after the changeovers in middle-grade ED doctors only.

Conclusions: The present study has demonstrated associations between uRV and initial-visit triage category 3, age between 3 months and 5 years, and presentations because of infectious illness. Middle-grade doctor changeover was also associated with an increase in uRVs.

Keywords: diagnostic error; hospital; medical staff; paediatric emergency medicine; patient readmission; seasonal variation.

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