Short-Term Revisits to Emergency Medical Center

ABSTRACT

PURPOSE: More than a few patients revisit Emergency Departments (EDs) with the same complaint. It is generally assumed that a revisit within a short period happens due to an inadequate evaluation during the previous visit, which creates a quality problem in emergency care. The purpose of this study is to analyze patient's revisiting the ED within 48 hours after being discharged and to use this information as a tool for quality assurance in the ED. METHODS: We carried out a chart review of patients who have revisited the ED within 48 hours between March 1, 2000 and February 28, 2002. We divided the patients into three groups according to their age. Disease variables were analyzed according to the age groups and admission rates. RESULTS: A total of 78,182 patients visited the ED during the period. Of these, 66,974 patients were discharged from the ED and the others were admitted. Of these discharged, 1,012 patients revisited the ED with the same complaints within 48 hours. The common disease or complaint of the short-term revisiting patients in order were acute abdomen, acute pharyngotonsilitis, ureter stones, respiratory problems, etc. Admissions of revisiting patients were due to acute abdomen, acute gastroenteritis, acute appendicitis, intussucception, panperitonitis, ileus, etc. There were significantly different admission rates according to initial symptoms, diseases and the age group of the revisiting patient. CONCLUSION: For quality improvement of emergency care, we need to standardize a management protocol, and the guidance for patient care provided in this paper might be recommended. A short -stay unit in the ED may be useful in some cases.