Characteristics of patients who made a return visit within 72 hours to the emergency department of a Singapore tertiary hospital
| Autor: | Sherman Wei Qiang Lian, Nan Liu, Shu Fang Ho, Stephanie Man Chung Fook-Chong, Marcus Eng Hock Ong, Amy Hui Sian Chan |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Risk medicine.medical_specialty Abdominal pain China Multivariate analysis Psychological intervention Patient Readmission Tertiary Care Centers Patient safety Young Adult medicine Data Mining Electronic Health Records Humans Seniority Aged Quality of Health Care Retrospective Studies Aged 80 and over Singapore business.industry Retrospective cohort study General Medicine Emergency department Patient Acuity Middle Aged Patient Discharge Abdominal Pain Emergency medicine Multivariate Analysis Emergency Medicine Original Article Female Patient Safety medicine.symptom Triage business Emergency Service Hospital |
| Popis: | INTRODUCTION 72-hour emergency department (ED) reattendance is a widely-used quality indicator for quality of care and patient safety. It is generally assumed that patients who return within 72 hours of ED discharge (72-hour re-attendees) received inadequate treatment or evaluation. The current literature also suggests considerable variation in probable causes of 72-hour ED reattendances internationally. This study aimed to understand the characteristics of these patients at the ED of a Singapore tertiary hospital. METHODS We conducted a retrospective cohort study on all ED visits between 1 January 2013 and 31 December 2013. 72-hour re-attendees were compared against non-re-attendees based on patient demographics, mode of arrival, patient acuity category status (i.e. P1/P2/P3/P4), seniority ranking of doctor-in-charge and medical diagnoses. Multivariate analysis using the generalised linear model was conducted on variables associated with 72-hour ED re-attendance. RESULTS Among 104,751 unique patients, 3,065 (2.93%) were in the 72-hour re-attendees group. Multivariate analysis showed that the following risk factors were associated with higher risk of returning within 72 hours: male gender, older age, arrival by ambulance, triaged as P2, diagnoses of heart problems, abdominal pain or viral infection (all p < 0.001), and Chinese ethnicity (p = 0.006). There was no significant difference in the seniority ranking of the doctor-in-charge between both groups (p = 0.419). CONCLUSION Several patient and event factors were associated with higher risk of being a 72-hour re-attendee. This study forms the basis for hypothesis generation and further studies to explore reasons behind reattendances so that interventions can be developed to target high-risk groups. |
| Databáze: | OpenAIRE |
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