Sah Rajesh, Murmu L R, Aggarwal Praveen, Bhoi Sanjeev
Emergency Department, BP Koirala Institute of Health Sciences, Dharan, NPL.
Emergency Department, All India Institute of Medical Sciences, New Delhi, IND.
Cureus. 2022 Apr 9;14(4):e23975. doi: 10.7759/cureus.23975. eCollection 2022 Apr.
Background An unscheduled emergency department (ED) revisit is defined as a patient presenting to the ED with the same problem within 72 hours of discharge. The revisits result in overcrowding and compromise the care provided by the ED. We assume that the poor quality of care provided by the ED is the reason for revisiting. However, the circumstances surrounding these revisits are not well-understood. We conducted this study to understand the characteristics associated with the revisits. Objectives We aimed to identify the common causes of ED revisits within 72 hours of discharge and determine the outcome of these patients during the revisit. Methods We conducted a prospective observational study at a tertiary care center from July 2015 to June 2017, including patients presenting at the ED within 72 hours after their first visit. Our study selected 50 patients using a simple random sampling method and identified the leading causes of revisit as doctor-related, patient-related, and illness-related. Results We found that 56% (28/50) of patients returned to the ED for illness-related reasons, 26% (13/50) for doctor-related reasons, and 18% (9/50) for patient-related reasons. In addition, we found that 62% (31/50) of patients who returned to the ED within 72 hours required in-patient admission. Conclusion The most common cause of ED revisit was illness-related causes, and more than half of the patients during a revisit required in-patient admission. The modifiable causes of the ED revisit, such as doctor-related and patient-related factors, were discovered in this study. These findings may aid in reducing ED revisits and improving the ED quality.
背景 非计划中的急诊科(ED)复诊定义为患者在出院后72小时内因相同问题再次前往急诊科就诊。这些复诊导致急诊科过度拥挤,并影响了急诊科提供的护理质量。我们假设急诊科提供的护理质量差是复诊的原因。然而,这些复诊的具体情况尚不清楚。我们开展这项研究以了解与复诊相关的特征。
目的 我们旨在确定出院后72小时内急诊科复诊的常见原因,并确定这些患者复诊期间的结局。
方法 我们于2015年7月至2017年6月在一家三级医疗中心进行了一项前瞻性观察性研究,纳入首次就诊后72小时内前往急诊科就诊的患者。我们的研究采用简单随机抽样方法选取了50名患者,并将复诊的主要原因确定为与医生相关、与患者相关和与疾病相关。
结果 我们发现,56%(28/50)的患者因与疾病相关的原因返回急诊科,26%(13/50)因与医生相关的原因,18%(9/50)因与患者相关的原因。此外,我们发现72小时内返回急诊科的患者中有62%(31/50)需要住院治疗。
结论 急诊科复诊最常见的原因是与疾病相关的原因,且复诊期间超过一半的患者需要住院治疗。本研究发现了急诊科复诊的一些可改变的原因,如与医生相关和与患者相关的因素。这些发现可能有助于减少急诊科复诊并提高急诊科的质量。