Retrospective evaluation of RE-applications to Aydin Adnanmenderes University Hospital adult emergency departmentwithin 72 HOURS

Introduction and Aim: Unexpected re-admissions of patients discharged from the emergency department (AS) with similar complaints to the emergency department were defined as "Re-application". However, re-admissions to the emergency department within the first 72 hours after discharge are also possible. It is accepted as "Early Term Re-Application". Patients who reapply to the emergency department in the early period are used as a quality indicator of hospitals. These patients increase the workload and health expenditures of hospitals, cause an increase in the density of the emergency services and cause medical and legal problems for patients and doctors. The aim of this study is to determine the demographic and clinical characteristics of patients who reapplied to the Aydın Adnan Menderes University Training and Research Hospital Emergency Service with the same or similar complaints in the early period between 15.12.2020 and 15.12.2021, to determine the rate of re-admissions, and to determine the medical, institutional or to identify individual risk factors. Material method: This study was carried out at Aydın Adnan Menderes University Practice and Research Hospital. It is a cross-sectional and descriptive study. All patients who reapplied to our emergency department with the same or similar complaints within 72 hours between 15.12.2020 and 15.12.2021 were included in the study. As a data collection tool, a data recording form consisting of 23 questions prepared by the researcher, developed in line with the relevant literature, was used. Information about demographic characteristics, admission complaint, emergency service complaint, laboratory, radiology, consultation and history were obtained as study data. Research data were evaluated using SPSS 21.0 statistical program. Results: In our study, all emergency service applications between the years 15.12.2020 and 15.12.2021 were evaluated, and it was determined that the number of those who applied to the emergency service with the same or similar complaints within 72 hours was 958. Of the patients included in our study, 517 (54.0%) were female and 441 (46.0%) were male. The mean age was 47.4±19.9 years. Between the first and second admissions to 37 the emergency department, blood tests, radiological imaging and consultation were requested at statistically significantly different rates. Of the patients, 73.1% were discharged, 18.0% were admitted to the service, 5.2% were admitted to the ICU, 3.2% were discharged at their own request, 0.3% were referred It was determined that 0.2% of them died. When the transactions between the first and second applications were evaluated, it was seen that the consultation was requested statistically significantly more in the second application than in the first application. Conclusion: The examination of re-admissions to the emergency department is an issue that needs to be studied in order to improve patient care and improve the quality of patient care. In our study, abdominal pain and shortness of breath were the most common symptoms in EPRV cases. We think that when these conditions, which are non-specific and can occur in a wide range of diseases, are evaluated in a more detailed examination period, there may be a decrease in re-admissions. At the same time, when hospitalized cases were evaluated in our study, the consultation rate was found to be significantly higher at their second admission. Perhaps lowering the consultation threshold in selected patient groups at first admission may initiate a faster treatment process and reduce EPRV rates. Reducing the unnecessary density in EDs, prolonging the ED observation period in selected patients, lowering the consultation threshold especially in elderly patients, detailed examination and examination evaluation, providing more detailed information about their current condition, and arranging their follow-up and treatment in order to keep their diseases under control in the long term. We think it can be reduced. Keywords: Emergency service, Quality indicator, Reapplication.