Early reattenders to the paediatric emergency department: A prospective cohort study and multivariate analysis.

J Paediatr Child Health

Paediatric Emergency Department, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, United Kingdom.

Published: September 2022

AI Article Synopsis

  • The study investigates factors predicting early unplanned reattendances in a pediatric emergency department (PED), with rates currently exceeding the UK target of 1-5%.
  • Over a year, data on 19,420 initial visits were analyzed, revealing a 7.5% reattendance rate linked to factors like young age and certain medical diagnoses, while clinician experience influenced outcomes.
  • The findings emphasize the importance of a 7-day observation period for assessing reattendances, suggesting that a shorter timeframe could overlook significant cases.

Article Abstract

Aims: The rate of unplanned reattendances is used as an indicator of the quality of care delivered in a paediatric emergency department (PED). With early reattendance in the UK well above the national target of 1-5%, we aimed to identify the factors which predict unplanned early reattendance to the PED.

Methods: This is a prospective, single-centre cohort study undertaken over 12 months. Data were collected on all patients who reattended the PED within 7 days of their initial visit as well as for a comparative cohort of patients with no visit in the preceding or subsequent 7 days. Multiple patient and departmental variables were recorded and analysed using a multivariate regression model.

Results: There were a total of 19 420 index visits to the PED, of which 1461 patients had an unscheduled reattendance within 7 days - a rate of 7.5%. Factors associated with unplanned but related reattendance include young age and diagnosis with a respiratory or other medical illness. Interestingly, the grade of clinician appeared to be relevant with patients seen by junior members of the medical team less likely to reattend. Acuity of illness was not a significant factor. A substantial number of unplanned early reattenders (36.3%) would have been missed had a time period of 72 h been used rather than 7 days.

Conclusions: This study identifies the typical patient who will have an unplanned, related early reattendance to a PED. This study also supports the use of a 7-day time period when using early reattendance as a performance indicator.

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Source
http://dx.doi.org/10.1111/jpc.16061DOI Listing

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