Elements affecting emergency department rate of return within 72 hours: a retrospective cross-sectional study

Authors

  • Mohammed A. Alazzawi Emergency Department, Mediclinic Welcare Hospital, Dubai, United Arab Emirates
  • Ahmad O. Hamdan Emergency Department, Mediclinic Welcare Hospital, Dubai, United Arab Emirates

DOI:

https://doi.org/10.18203/issn.2454-2156.IntJSciRep20231094

Keywords:

Emergency departments, Unplanned return visit, Hospital

Abstract

Background: Many patients view emergency departments (EDs) as their top choice for medical problems because they act as an easily accessible entry point into the healthcare system. The frequency of ED visits, the causes, and the burden must be considered to evaluate the quality and outcome of care. The researcher aimed to investigate the elements that affect the rate of return to the emergency department within 72 hours. In addition, to determine the underlying factors associated with unplanned ED return visits.

Methods: It was a retrospective cross-sectional study.  

Results: The result of this study shows that 1535 unplanned ED return visits out of 53387. The rate was 2.9%. A total of 339 (22%) patients of unplanned ED returned visits were admitted to the hospital which is representing 8% of the total hospital admission from ED.

Conclusions: The study found that certain types of presenting complaints, such as fever, cough, and throat pain related to respiratory tract infection, were associated with a higher rate of unplanned return at a rate of 33% (513). The results of this study suggest that interventions aimed at improving access to follow-up care, and patient education with effective communication. In addition, continuously monitoring the rate of unplanned ED return and linking that rate to the ED physician's individual performance review might effectively reduce the rate and improve the quality and outcome of care.

Metrics

Metrics Loading ...

References

Centres for Disease Control and Prevention. Emergency department - Health, United States. 2022. Available at: https://www.cdc.gov/nchs/hus/sources-definitions/emergency-department.htm. Accessed on 12 January 2023.

Sah R, Murmu LR, Aggarwal P, Bhoi S. Characteristics of an Unscheduled Emergency Department Revisit Within 72 hours of Discharge. Cureus. 2022;14(4):e23975.

Study.com. Self-Regulation Theory. 2023. Available at: https://study.com/learn/lesson/self-regulation-theory-overview-components-strategies.html. Accessed on 02 February 2023.

Ryan P, Sawin KJ. The individual and family self-management theory: Background and perspectives on context, process, and outcomes. Nursing Outlook. 2009;57(4):217-25.

Alshahrani M, Katbi F, Bahamdan Y, Alsaihati A, Alsubaie A, Althawadi D, et al. Frequency, Causes, and Outcomes of Return Visits to the Emergency Department Within 72 Hours: A Retrospective Observational Study. J Multidiscip Healthc. 2020;13:2003-10.

Mathew N, Guttikonda A, Mitra S, Vijay JJ, Abhilash KPP. Emergency department revisits within 72 hours to a tertiary care referral hospital in South India. Current Medical Issues. 2020;18(1):23.

Navanandan N, Schmidt SK, Cabrera N, Topoz I, DiStefano MC, Mistry RD. Seventy-two-hour Return Initiative: Improving Emergency Department Discharge to Decrease Returns. Pediatr Qual Saf. 2020;5(5):e342.

Rising KL, Victor TW, Hollander JE, Carr BG. Patient returns to the emergency department: the time-to-return curve. Acad Emerg Med. 2014;21(8):864-71.

Alsabri M, Boudi Z, Zoubeidi T, Alfaki IA, Levy P, Oneyji C, et al. Analysis of Risk Factors for Patient Safety Events Occurring in the Emergency Department. J Patient Saf. 2022;18(1):e124-35.

Jimenez MLCD, Manzanera RL, Abeleda RD, Moya DA, Segura JV, Carascal MB, et al. Factors affecting 72-hour unplanned return visits after emergency department index discharge of a tertiary private hospital in the Philippines. Acta Medica Philippina. 2020;54(5).

Chan AH, Ho SF, Fook-Chong SM, Lian SW, Liu N, Ong ME. Characteristics of patients who made a return visit within 72 hours to the emergency department of a Singapore tertiary hospital. Singapore Med J. 2016;57(6):301-6.

Improving the Emergency Department Discharge Process: Environmental Scan Report. 2014. Available at: https://www.ahrq.gov/sites/default/files /wysiwyg/professionals/systems/hospital/edenvironmentalscan/edenvironmentalscan.pdf. Accessed on 02 February 2023.

Nasradeen MH, Althunayan MI, Aljamaan AK, Aljehani AM, Alqahtani FB, Aljerian N, et al. Reasons for unscheduled return visits within 72 hours to the adult emergency department in Riyadh. Saud J Emerg Med. 2021;2(2):112.

Cheng J, Shroff A, Khan N, Jain S. Emergency department return visits resulting in admission: do they reflect quality of care? Am J Med Quality. 2016;31(6):541-51.

Liu SW. Risk factors of admission in 72-h return visits to emergency department. Tzu-Chi Med J. 2021;33(2):169.

Augustine JJ. Return ED Visits: Poor Performance or Flawed Metric? Available at: https://www.acepnow. com/article/return-ed-visits-poor-performance-flawed-metric/. Accessed on 02 February 2023.

Ling DA, Sung CW, Fang CC, Ko CH, Chou EH, Herrala J, et al. High-risk Return Visits to United States Emergency Departments, 2010-2018. West J Emerg Med. 2022;23(6):832-40.

Hiti EA, Tamim H, Makki M, Geha M, Kaddoura R, Obermeyer Z. Characteristics and determinants of high-risk unscheduled return visits to the emergency department. Emerg Med J. 2020;37(2):79-84.

Cairns C, Kang K. National hospital ambulatory medical care survey: 2019 emergency department summary tables. 2022. Available at: https:// openminds.com/market-intelligence/resources/ 082222nhamcs2019edtables/. Accessed on 02 February 2023.

Davazdahemami B, Peng P, Delen D. A deep learning approach for predicting early bounce-backs to the emergency departments. Healthcare Analytics. 2022;2:100018.

Downloads

Published

2023-04-26

Issue

Section

Original Research Articles