Unplanned Emergency Department Revisits within 72 Hours

Abstract

Objective: This study was carried out to identify common and serious cases of Emergency Department (ED) revisits and to find out the initial ED presentations that affect such revisits. Materials and Methods: There were 5423 non-traumatic, non-pediatric cases that visited a medical center ED located in southern Taiwan in September 2001. The cases that revisited the ED within 72 hours were retrospectively identified by one of the authors and two of the other authors independently examined all charted revisits to determine the causes of the revisits. Results: Three hundred sixteen cases (5.8%) were found have revisited the ED within 72 hours after their initial visit. The rates of revisits related to factors of illness, patients, and doctors accounted for 62.1%, 14.2% and 23.7%, respectively. Among the factor of the doctors, 9.0% (21 case) were due to misdiagnosis and abdominal pain was the most common presentation (66.7%, 14/21). Conclusions: Differentiation between the natural course of a disease, suboptimal therapy, over anxious reaction, and medical errors is difficult. Taking the rate of revisits as an index to gauge the performance of the ED is far from ideal. Good communication skills and good patient-physician relationship are much important than revisits rate in the quality assurance of emergency care.