Characteristics of the patients with unexpected emergency department revisits

Emergency departments are busy units with an intense patient circulation and rushed decisions has to be made. Thus some patients, from time to time can revisit for different reasons. This situation might cause unfavorable consequences for the patient and ED. So in this study we aimed to find out the common causes of these revisits and patient characteristics. This study took place between January 7th - March 5th 2016 in Akdeniz University Hospital Emergency Department, where annually approximately 95.000 patients visit. We enrolled all the patients over 18 years old and all the trauma patients regardless of their age who had any other doctor or health institution visit with the same complaint in last seven days. We took informed consent from the patients or their relatives. The collected data were put into SPSS 16.0 and for statistical analysis chi square and Mann Whitney U tests we used. We enrolled 1066 patients. Among 15922 total ED visits, these 1066 (6,69%) were return visits. Main patient complaint for revisit was lacerations/burns/trauma, followed by dyspnea and cough. Top reason for revisit was with a percentage of 40,2% (429 patients) ''continuing complaints / symptoms'', at the second place was ''insufficient utilities'' with 240 patients (22,5%) and the third reason was dissatisfaction by the initial visit with 197 patients (18,5%). We determined a statistical significance between first visit admission rates and revisit admission rates (13% vs 26%, p=0,033). Another statistically significant data we obtained was the admission rates were higher in patients whose initial visit wasn't to the University Hospital (29,5% to 20%, p=0,033). Only 4,1% of patients were transferred to our ED with an appropriate transfer procedure. These unexpected return visits to ED's can't be neglected. When we take a close look at the revisit reasons, providing a more careful healthcare plus better transfer prosedures for institutions with insufficient utilities might decrease unexpected revisits, increase healthcare quality and help prevent overcrowding in ED's.