Wong T W, Lam K W
Accident and Emergency Department, Kwong Wah Hospital, Yaumati, Hong Kong.
J Accid Emerg Med. 1994 Dec;11(4):213-7. doi: 10.1136/emj.11.4.213.
A study was carried out in an inner-city emergency department (ED) of patients returning for related complaints within 48 h of discharge. The incidence was around 0.7% and the majority (82%) of patients presented with persistence or progression of the original symptoms. Patient-related factors accounted for 13% of returns and only 5% were found to be the result of doctor-related factors. Of the returnees, 54% were discharged and 36% were admitted. The most common initial complaint was pain (31%) which, in 23% of patients, was localized to the abdomen. Injury (14%) and febrile illnesses (13%) came second and third. Asthma and chronic obstructive airway diseases (COAD) also accounted for 8% of cases. Children of less than 10 years of age were more likely to return within 48 h. About 18% of cases were thought to be potentially avoidable. Better patient education and an improvement in primary health care services were thought to be important in decreasing such avoidable reattendance. Reattendance audit was a useful tool in the continuous quality improvement programme of emergency department.
一项针对城市中心急诊科出院后48小时内因相关症状复诊患者的研究展开。复诊发生率约为0.7%，大多数（82%）患者表现为原有症状持续或加重。与患者相关的因素占复诊原因的13%，而医生相关因素导致的复诊仅占5%。在复诊患者中，54%被再次出院，36%被收治入院。最常见的初始症状是疼痛（31%），其中23%的患者疼痛局限于腹部。损伤（14%）和发热性疾病（13%）位列第二和第三。哮喘和慢性阻塞性气道疾病（COAD）也占病例的8%。10岁以下儿童在48小时内复诊的可能性更大。约18%的病例被认为是潜在可避免的。改善患者教育和提升初级卫生保健服务被认为对减少此类可避免的再次就诊至关重要。复诊审核是急诊科持续质量改进项目中的一个有用工具。
