Bounce-back visits in a rural emergency department

The rate of return visits at urban emergency departments (EDs) has been reported as approximately 3% within 72 hours of discharge. However, the current literature does not indicate the rate of return visits for rural EDs. The purpose of this study was to determine the bounce-back rate at a rural ED and to characterize the visits.

A retrospective chart review was performed on all visits to the ED of the South Huron Hospital between Apr. 1, 2007, and Mar. 31, 2008. Charts were reviewed for patient age, Canadian Emergency Department Triage and Acuity Scale (CTAS) score, most common diagnoses and discharge disposition for each visit.

Of the 9935 ED visits during this 12-month period, 289 (2.9%) were return visits within 72 hours. Median patient age was 46 years. The most common CTAS score for return visits was CTAS-IV (45.3%). The most common diagnosis was unspecified abdominal pain (4.0%). Most patients (88.6%) were treated in the ED and discharged home.

This study demonstrates that the bounce-back rate at a rural ED is similar to that at an urban ED. Most return visits are for low-acuity conditions, and unspecified abdominal pain represents the most common return diagnosis.