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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

Unscheduled return visits to a pediatric emergency department

1
Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Lithuania
2
Department of Preventive Medicine, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
3
Department of Children Diseases, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
4
Department of Rehabilitation, Physical and Sports Medicine, Faculty of Medicine, Vilnius University, Lithuania
*
Author to whom correspondence should be addressed.
Medicina 2017, 53(1), 66-71; https://doi.org/10.1016/j.medici.2017.01.003
Received: 20 February 2016 / Revised: 4 January 2017 / Accepted: 5 January 2017 / Published: 31 January 2017
Background and objective: Return visits (RVs) to a pediatric emergency department (ED) within a short period after discharge have an influence on overcrowding of the ED and reveal some weaknesses of the health care system. The aim of this study was to determine the rate of RVs and factors related to RVs to the pediatric ED in Lithuania.Materials and methods: A retrospective study in an urban, tertiary-level teaching hospital was carried out. Electronic medical records of all patients (n = 44 097) visiting the ED of this hospital between 1 January and 31 December 2013 were analyzed. Demographic and clinical characteristics of patients who return to the ED within 72 h and those who had not visited the ED were compared. Factors associated with RVs were determined by multivariable logistic regression.Results: Of the overall ED population, 33 889 patients were discharged home after the initial assessment. A total of 1015 patients returned to the ED within 72 h, giving a RV rate of 3.0%. Being a 0–7-year old, visiting the ED during weekdays, having a GP referral, receiving of laboratory tests and ultrasound on the initial visit were associated with greater likelihoods of returning to the ED. Patients who arrived to the ED from 8:01 a.m. to 4:00 p.m. and underwent radiological test were less likely to return to the ED within 72 h. Diseases such as gastrointestinal disorders or respiratory tract/earth–nose–throat (ENT) diseases and symptoms such as fever or pain were significantly associated with returning to the ED. The initial diagnosis corresponded to the diagnosis made on the second visit for only 44.1% of the patients, and the highest rate of the congruity in diagnosis was for injuries/poisoning, surgical pathologies (77.2%) and respiratory tract diseases (76.9%).Conclusions: RVs accounted for only a small proportion of visits to the ED. RVs were more prevalent among younger patients and patients with a GP referral as well as performed more often after discharging from the ED in the evening and at night. View Full-Text
Keywords: Pediatric emergency department; Return visit; Urgent care; Children; Overcrowding Pediatric emergency department; Return visit; Urgent care; Children; Overcrowding
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Burokienė, S.; Kairienė, I.; Strička, M.; Labanauskas, L.; Čerkauskienė, R.; Raistenskis, J.; Burokaitė, E.; Usonis, V. Unscheduled return visits to a pediatric emergency department. Medicina 2017, 53, 66-71.

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