Header

UZH-Logo

Maintenance Infos

Unplanned Return Visits to a Pediatric Emergency Department


Seiler, Michelle; Furrer, Pascal Raffael; Staubli, Georg; Albisetti, Manuela (2019). Unplanned Return Visits to a Pediatric Emergency Department. Pediatric Emergency Care:Epub ahead of print.

Abstract

OBJECTIVES:

Unplanned return visits (URVs) to emergency departments (EDs) account internationally for 2.5% to 5.2% of all consultations. ED crowding is an increasing challenge, and URVs seem to contribute to this problem. This study aimed to assess factors for URVs at the ED of a tertiary children's hospital to analyze if they are jointly responsible for the steadily rising amount of treated patients.
METHODS:

All patients with an URV to a pediatric ED in Switzerland between January and December 2013 were included in the study. Data were taken retrospectively from the electronic patient files, and different variables were defined and analyzed.
RESULTS:

URVs occurred at an incidence of 4.6%, and mostly concerned infants and toddlers (46%). URVs were independent of weekdays and mostly occurred between 10 AM and 10 PM. In 84.2% of the cases, the URVs were judged as unnecessary, and in 15.8%, a hospitalization was indicated, mainly for children with a worsening respiratory illness.
CONCLUSIONS:

The occurrence of URVs in our ED was within the incidence reported in the literature. While URVs lead to hospitalization in some patients, the majority of URVs were unnecessary from a medical point of view. These results indicate that a correct evaluation of the child's health state by parents is often challenging and requires repeated medical attendance following a first ED visit, especially in infants with airway diseases and infections. Intensive counseling and scheduled short-term follow-up consultation at the pediatrician's office could prevent URVs to the ED.

Abstract

OBJECTIVES:

Unplanned return visits (URVs) to emergency departments (EDs) account internationally for 2.5% to 5.2% of all consultations. ED crowding is an increasing challenge, and URVs seem to contribute to this problem. This study aimed to assess factors for URVs at the ED of a tertiary children's hospital to analyze if they are jointly responsible for the steadily rising amount of treated patients.
METHODS:

All patients with an URV to a pediatric ED in Switzerland between January and December 2013 were included in the study. Data were taken retrospectively from the electronic patient files, and different variables were defined and analyzed.
RESULTS:

URVs occurred at an incidence of 4.6%, and mostly concerned infants and toddlers (46%). URVs were independent of weekdays and mostly occurred between 10 AM and 10 PM. In 84.2% of the cases, the URVs were judged as unnecessary, and in 15.8%, a hospitalization was indicated, mainly for children with a worsening respiratory illness.
CONCLUSIONS:

The occurrence of URVs in our ED was within the incidence reported in the literature. While URVs lead to hospitalization in some patients, the majority of URVs were unnecessary from a medical point of view. These results indicate that a correct evaluation of the child's health state by parents is often challenging and requires repeated medical attendance following a first ED visit, especially in infants with airway diseases and infections. Intensive counseling and scheduled short-term follow-up consultation at the pediatrician's office could prevent URVs to the ED.

Statistics

Citations

Dimensions.ai Metrics

Altmetrics

Downloads

3 downloads since deposited on 15 Jan 2020
3 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:Pediatrics, Perinatology, and Child Health, Emergency Medicine, General Medicine
Language:English
Date:1 March 2019
Deposited On:15 Jan 2020 13:29
Last Modified:01 Mar 2020 01:00
Publisher:Lippincott Williams & Wilkins
ISSN:0749-5161
OA Status:Green
Publisher DOI:https://doi.org/10.1097/pec.0000000000001764
PubMed ID:30829838

Download

Green Open Access

Download PDF  'Unplanned Return Visits to a Pediatric Emergency Department'.
Preview
Content: Published Version
Filetype: PDF
Size: 359kB
View at publisher