Pierce J M, Kellerman A L, Oster C
Department of Medicine, University of Tennessee, Memphis.
Ann Emerg Med. 1990 Jul;19(7):752-7. doi: 10.1016/s0196-0644(05)81698-1.
From July through September 1987, our emergency department registered 17,214 patients, of whom 569 (3%) returned within two days of initial registration. Cases were reviewed to identify factors associated with return visits. Patient-related factors were responsible for a majority of repeat visits (267 cases, 53%). Illness-related factors, particularly evolution of disease under close outpatient observation, prompted return in 68 cases (13%). An additional 60 patients (12%) returned with new problems unrelated to their initial presentation. Physician-related factors were the primary reason for return in 92 cases (18%). Problems with our public health-care system prompted return in 18 cases (4%). Eighty-seven returning patients (19%) required emergency hospitalization, including 28 discharged due to physician errors. Regular case review of short-term returns to the ED should be included in a comprehensive ED-based program of quality assurance.
1987年7月至9月期间，我们急诊科登记了17214名患者，其中569名（3%）在首次登记后的两天内复诊。对病例进行了审查，以确定与复诊相关的因素。与患者相关的因素导致了大多数的复诊（267例，53%）。与疾病相关的因素，特别是在门诊密切观察下疾病的进展，促使68例（13%）患者复诊。另外60名患者（12%）因与初次就诊无关的新问题而复诊。与医生相关的因素是92例（18%）患者复诊的主要原因。我们公共卫生保健系统的问题导致18例（4%）患者复诊。87名复诊患者（19%）需要紧急住院治疗，其中28例因医生失误而出院。对急诊科短期复诊进行定期病例审查应纳入基于急诊科的全面质量保证计划中。
