Patterns of return visits to the Emergency Department among adult patients: an experience from tertiary hospital

Abstract

Background: The rate of return visits to the emergency department is considered an important quality of care indicator and a tool for improving the quality of care provided to ED patients as well as patient safety. The aim of this study was to determine the patterns of adult (>18 years) return visits within 48 hours to the emergency department to identify the rate of return visits to the Sultan Qaboos University Hospital ED. Methods: The medical records from Track Care system of all adult patients revisiting the ED of Sultan Qaboos University Hospital between May 2016 and October 2016 were reviewed retrospectively in terms of patient demographic information, date and time presenting to ED, chief presenting complaint, diagnoses, triage level 1-5 and final disposition. Results: The total number of return visits made by adults included in this study were 401 return visits, the remaining return visits representing pediatric visits and missed data visits thus were excluded from our study. The rate of return visits among adult patients was 1.5%. The majority of return visit patients were females (60.6%). They were mostly presenting with obstetric problems (21.9%). The most common age group was young adults (18-35 years old ) (63.8%) and was most commonly presenting again with the same complaint. Elderly patients usually revisited with worsening of their clinical condition or development of new symptoms. Most of the patients who were discharged from ED were admitted on their return visit (84.3%). The majority of patients came back within a length of the period between two visits 12 – 24 hours (35.9%) and the shortest period between the two visits was 8.6 minutes. Most patients visited the ED during the evening shift (36.2%) and were categorized into triage Level III (50.4%) during their first ED visit. Conclusion: This study demonstrated a similar rate of return visits compared to previous studies in different countries. Return visits to ED are common mostly by patients who presented with the same initial complaint and non-urgent condition. Most of the return visits were made by obstetric patients. Further studies are required in the future for reasons and risk factors of revisits. [SJEMed 2020; 1(1.100): 10S-10S]

Keywords

• return visits
• emergency department
• squh