Unplanned return visits to emergency in a regional hospital
Sue E. Kirby A B , Sarah M. Dennis A , Upali W. Jayasinghe A and Mark F. Harris AA Centre for Primary Health Care and Equity, School of Public Health & Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia.
B Corresponding author. Email: s.kirby@student.unsw.edu.au
Australian Health Review 36(3) 336-341 https://doi.org/10.1071/AH11067
Submitted: 17 July 2011 Accepted: 22 December 2011 Published: 27 July 2012
Abstract
Objective. The aim of this study was to determine the patient characteristics associated with unplanned return visits, using routinely collected hospital data, to assist in developing strategies to reduce their occurrence.
Methods. Emergency department data from a regional hospital were analysed using univariate and multivariate methods to determine the influence of clinical, service usage and demographic patient characteristics on unplanned return visits.
Results. Around 80% of the 16 000 patients attending emergency presented on only one occasion in a year. Five per cent of patients presented with an unplanned return visit. Older patients, those with minor and low urgency conditions and with non-psychotic mental health conditions, those presenting during winter and after hours were significantly more likely to present as unplanned return visits.
Conclusion. Although patient characteristics associated with unplanned return visits have been identified, the reasons underpinning the unplanned return visit rate, such as patient service preference and attitudes, need to be more fully investigated.
What is known about the topic? Patients who present as unplanned return visits are older and have a range of chronic and acute conditions. Some unplanned return visits occur because of limited access to other non-hospital service.
What does this paper add? This paper adds to the field by providing information from a regional hospital in NSW Australia on the patient characteristics associated with unplanned return visits. It provides a basis for differentiating between other groups of frequent emergency department patients. However, the reasons behind the unplanned return visit rate need to be more fully investigated.
What are the implications for practitioners? The implications of the findings of this study for policy makers, administrators and clinicians are that access to alternative services for the conditions associated with unplanned return visits need to be further investigated in the context of the role for emergency department services.
Additional keywords: disease management, emergency medical services, health services accessibility, patient care management.
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