Predicting Factors and Risk Stratification for Return Visits to the Emergency Department Within 72 Hours in Pediatric...

Area of Science:

• Pediatric Emergency Medicine
• Healthcare Quality Improvement
• Health Services Research

Background:

• Return visits (RVs) to the emergency department (ED) serve as a critical quality indicator for healthcare facilities.
• Understanding factors influencing pediatric RVs is essential for enhancing emergency care quality.

Purpose of the Study:

• To identify pediatric patients at high risk for return visits to the ED.
• To utilize readily available patient characteristics during an ED visit for risk stratification.

Main Methods:

• Retrospective analysis of 35,435 pediatric ED visits from an urban hospital network in 2007.
• Multivariable logistic regression and classification and regression tree techniques were employed to identify risk factors and high-risk groups.

Main Results:

• A 6.47% rate of RVs within 72 hours was observed among discharged pediatric patients.
• Factors associated with increased RV probability included younger age, weekday visits, symptom-based diagnoses, and care by a female physician.
• Children under 6.5 years visiting on weekdays or during specific early morning weekend/holiday hours showed the highest RV risk.

Conclusions:

• The study identified key factors contributing to pediatric ED return visits.
• Specific high-risk groups for RVs were identified, suggesting targeted interventions.
• Further research, including intervention studies, should focus on these identified at-risk pediatric populations.