Paediatric Department, Princess Royal University Hospital, Farnborough, Kent, UK.
Arch Dis Child. 2013 Mar;98(3):211-3. doi: 10.1136/archdischild-2012-302836. Epub 2013 Jan 2.
The new accident and emergency (A&E) unplanned reattendance rate clinical quality indicator is intended to drive reduction of avoidable reattendances. Validation data for reattendance rates in children are awaited. The aim of this three site observational study is to establish the rate and reasons for unplanned reattendance to UK paediatric A&Es. Each centre undertook retrospective case note review of children attending at least twice within 7 days. Unplanned reattendance rates at the three centres were 5.1%, 5.2% and 4.4%. Reducing unnecessary unplanned reattendances is beneficial for patients, service capacity and efficacy. This study has identified two groups for targeting reattendance reduction: parents of children returning with the same diagnosis, severity unchanged and parents who bypass primary care resources. Clear communication and early involvement of experienced clinicians are paramount. This study has indicated that a 1%-5% unplanned reattendance rate is realistic, achievable and can drive improvement in children's services.
新的意外和急诊（A&E）非计划性再就诊率临床质量指标旨在降低可避免的再就诊率。目前正在等待儿童再就诊率的验证数据。本三项观察性研究旨在确定英国儿科 A&E 中儿童非计划性再就诊的发生率和原因。每个中心都对至少在 7 天内两次就诊的儿童进行了回顾性病历审查。三个中心的非计划性再就诊率分别为 5.1%、5.2%和 4.4%。减少不必要的非计划性再就诊对患者、服务能力和疗效都有益处。本研究确定了两个目标人群以减少再就诊率：儿童返回时诊断相同、严重程度不变的父母，以及绕过初级保健资源的父母。明确的沟通和经验丰富的临床医生的早期参与至关重要。本研究表明，1%-5%的非计划性再就诊率是现实的、可实现的，并且可以推动儿童服务的改善。
