Prevalence and predictors of return visits to pediatric emergency departments.
J Hosp Med
; 9(12): 779-87, 2014 Dec.
Article
em En
| MEDLINE
| ID: mdl-25338705
ABSTRACT
OBJECTIVE:
To determine the rate of return visits to pediatric emergency departments (EDs) and identify patient- and visit-level factors associated with return visits and hospitalization upon return. DESIGN ANDSETTING:
Retrospective cohort study of visits to 23 pediatric EDs in 2012 using data from the Pediatric Health Information System.PARTICIPANTS:
Patients <18 years old discharged following an ED visit.MEASURES:
The primary outcomes were the rate of return visits within 72 hours of discharge from the ED and of return visits within 72 hours resulting in hospitalization.RESULTS:
1,415,721 of the 1,610,201 ED visits to study hospitals resulted in discharge. Of the discharges, 47,294 patients (3.3%) had a return visit. Of these revisits, 9295 (19.7%) resulted in hospitalization. In multivariate analyses, the odds of having a revisit were higher for patients with a chronic condition (odds ratio [OR] 1.91, 95% confidence interval [CI] 1.86-1.96), higher severity scores (OR 1.42, 95% CI 1.40-1.45), and age <1 year (OR 1.32, 95% CI 1.22-1.42). The odds of hospitalization on return were higher for patients with higher severity (OR 3.42, 95% CI 3.23-3.62), chronic conditions (OR 2.92, 95% CI 2.75-3.10), age <1 year (1.7-2.5 times the odds of other age groups), overnight arrival (OR 1.84, 95% CI 1.71-1.97), and private insurance (OR 1.47, 95% CI 1.39-1.56). Sickle cell disease and cancer patients had the highest rates of return at 10.7% and 7.3%, respectively.CONCLUSIONS:
Multiple patient- and visit-level factors are associated with revisits. These factors may provide insight in how to optimize care and decrease avoidable ED utilization.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Readmissão do Paciente
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Serviço Hospitalar de Emergência
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Hospitais Pediátricos
Tipo de estudo:
Etiology_studies
/
Incidence_studies
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Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
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Newborn
Idioma:
En
Revista:
J Hosp Med
Ano de publicação:
2014
Tipo de documento:
Article