Identifying return visits to the Emergency Department: A multi-centre study.

Area of Science:

• Emergency Medicine
• Healthcare Quality Improvement
• Patient Safety

Background:

• Unplanned return visits to the Emergency Department (ED) pose risks to patients.
• Monitoring ED return visits is vital for evaluating care quality, but the 48-hour benchmark lacks robust evidence.

Purpose of the Study:

• To determine the incidence, characteristics, and outcomes of unplanned ED return visits.
• To assess the capture rate of the 48-hour benchmark for ED return visits.

Main Methods:

• Retrospective cross-sectional study of 164,598 ED presentations across three Sydney EDs (July 2017-June 2018).
• Return visits defined as presentations within 28 days with similar complaints post-discharge.
• Descriptive statistics and appropriate statistical tests (Chi-square, Mann-Whitney, t-tests) were used for analysis.

Main Results:

• 3.6% (5860) of ED presentations were identified as return visits.
• The median time to return was 64.8 hours; only 43% returned within 48 hours.
• Abdominal, urological, and mental health issues were the most common reasons for return visits.

Conclusions:

• The 48-hour benchmark significantly underestimates the incidence of ED return visits.
• Policymakers should consider extending the 48-hour benchmark to better reflect return visit rates.
• Further research into the causes of return visits, especially for abdominal, urological, and mental health complaints, is recommended.