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Rates and causes of emergency department revisits within 72 hours
S J Liaw1, M J Bullard, P M Hu
1Department of Emergency Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan.
Journal of the Formosan Medical Association = Taiwan Yi Zhi
|August 12, 1999
Summary
Most emergency department (ED) revisits within 72 hours are due to disease factors, not medical errors. This study establishes baseline revisit rates for future audits and identifies areas for potential improvement in patient care.
Area of Science:
- Emergency Medicine
- Healthcare Management
- Patient Safety
Background:
- High rates of emergency department (ED) revisits can indicate underlying issues in patient care and resource allocation.
- Establishing baseline data is crucial for developing effective quality improvement initiatives and audit systems.
Purpose of the Study:
- To determine the rates and causes of emergency department (ED) revisits within 72 hours.
- To identify areas for improvement in ED patient management.
- To generate baseline data for a computerized monthly audit system.
Main Methods:
- Retrospective chart review of patients returning to the ED within 72 hours over a two-year period.
- Calculation of monthly revisit rates and analysis of contributing factors.
- Independent review of a sample of 485 revisit cases to determine causes.
Main Results:
- Monthly ED revisit rates ranged from 1.32% to 2.38% without significant seasonal patterns.
- Disease factors accounted for 79.0% of revisits; medical errors were implicated in 7.8%.
- Patients revisited due to medical errors had a higher subsequent hospital admission rate (73.7%).
Conclusions:
- The established baseline monthly ED revisit rate is approximately 2%.
- Most revisits are disease-related, but medical errors warrant further investigation.
- Prospective studies are recommended to identify and address common causes of revisits for improved patient outcomes.