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Unscheduled return visits to a Dutch inner-city emergency department

BACKGROUND: Unscheduled return visits to the emergency department (ED) may reflect shortcomings in care. This study characterized ED return visits with respect to incidence, risk factors, reasons and post-ED disposition. We hypothesized that risk factors for unscheduled return and reasons for return...

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Autores principales: van der Linden, M Christien, Lindeboom, Robert, de Haan, Rob, van der Linden, Naomi, de Deckere, Ernie RJT, Lucas, Cees, Rhemrev, Steven J, Goslings, J Carel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4100563/
https://www.ncbi.nlm.nih.gov/pubmed/25045407
http://dx.doi.org/10.1186/s12245-014-0023-6
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author van der Linden, M Christien
Lindeboom, Robert
de Haan, Rob
van der Linden, Naomi
de Deckere, Ernie RJT
Lucas, Cees
Rhemrev, Steven J
Goslings, J Carel
author_facet van der Linden, M Christien
Lindeboom, Robert
de Haan, Rob
van der Linden, Naomi
de Deckere, Ernie RJT
Lucas, Cees
Rhemrev, Steven J
Goslings, J Carel
author_sort van der Linden, M Christien
collection PubMed
description BACKGROUND: Unscheduled return visits to the emergency department (ED) may reflect shortcomings in care. This study characterized ED return visits with respect to incidence, risk factors, reasons and post-ED disposition. We hypothesized that risk factors for unscheduled return and reasons for returning would differ from previous studies, due to differences in health care systems. METHODS: All unscheduled return visits occurring within 1 week and related to the initial ED visit were selected. Multivariable logistic regression was conducted to determine independent factors associated with unscheduled return, using patient information available at the initial visit. Reasons for returning unscheduled were categorized into illness-, patient- or physician-related. Post-ED disposition was compared between patients with unscheduled return visits and the patients who did not return. RESULTS: Five percent (n = 2,492) of total ED visits (n = 49,341) were unscheduled return visits. Patients with an urgent triage level, patients presenting during the night shift, with a wound or local infection, abdominal pain or urinary problems were more likely to return unscheduled. Reasons to revisit unscheduled were mostly illness-related (49%) or patient-related (41%). Admission rates for returning patients (16%) were the same as for the patients who did not return (17%). CONCLUSIONS: Apart from abdominal complaints, risk factors for unscheduled return differ from previous studies. Short-term follow-up at the outpatient clinic or general practitioner for patients with urgent triage levels and suffering from wounds or local infections, abdominal pain or urinary problem might prevent unscheduled return.
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spelling pubmed-41005632014-07-18 Unscheduled return visits to a Dutch inner-city emergency department van der Linden, M Christien Lindeboom, Robert de Haan, Rob van der Linden, Naomi de Deckere, Ernie RJT Lucas, Cees Rhemrev, Steven J Goslings, J Carel Int J Emerg Med Original Research BACKGROUND: Unscheduled return visits to the emergency department (ED) may reflect shortcomings in care. This study characterized ED return visits with respect to incidence, risk factors, reasons and post-ED disposition. We hypothesized that risk factors for unscheduled return and reasons for returning would differ from previous studies, due to differences in health care systems. METHODS: All unscheduled return visits occurring within 1 week and related to the initial ED visit were selected. Multivariable logistic regression was conducted to determine independent factors associated with unscheduled return, using patient information available at the initial visit. Reasons for returning unscheduled were categorized into illness-, patient- or physician-related. Post-ED disposition was compared between patients with unscheduled return visits and the patients who did not return. RESULTS: Five percent (n = 2,492) of total ED visits (n = 49,341) were unscheduled return visits. Patients with an urgent triage level, patients presenting during the night shift, with a wound or local infection, abdominal pain or urinary problems were more likely to return unscheduled. Reasons to revisit unscheduled were mostly illness-related (49%) or patient-related (41%). Admission rates for returning patients (16%) were the same as for the patients who did not return (17%). CONCLUSIONS: Apart from abdominal complaints, risk factors for unscheduled return differ from previous studies. Short-term follow-up at the outpatient clinic or general practitioner for patients with urgent triage levels and suffering from wounds or local infections, abdominal pain or urinary problem might prevent unscheduled return. Springer 2014-07-05 /pmc/articles/PMC4100563/ /pubmed/25045407 http://dx.doi.org/10.1186/s12245-014-0023-6 Text en Copyright © 2014 van der Linden et al.; licensee Springer http://creativecommons.org/licenses/by/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
spellingShingle Original Research
van der Linden, M Christien
Lindeboom, Robert
de Haan, Rob
van der Linden, Naomi
de Deckere, Ernie RJT
Lucas, Cees
Rhemrev, Steven J
Goslings, J Carel
Unscheduled return visits to a Dutch inner-city emergency department
title Unscheduled return visits to a Dutch inner-city emergency department
title_full Unscheduled return visits to a Dutch inner-city emergency department
title_fullStr Unscheduled return visits to a Dutch inner-city emergency department
title_full_unstemmed Unscheduled return visits to a Dutch inner-city emergency department
title_short Unscheduled return visits to a Dutch inner-city emergency department
title_sort unscheduled return visits to a dutch inner-city emergency department
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4100563/
https://www.ncbi.nlm.nih.gov/pubmed/25045407
http://dx.doi.org/10.1186/s12245-014-0023-6
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