Alberto Jiménez-Puente1, José Del Río-Mata2, José Luis Arjona-Huertas3, Begoña Mora-Ordóñez4, Lourdes Nieto-de Haro4, Antonio Lara-Blanquer5, Alfonso Martínez-Reina2, Miguel Martínez Del Campo3. 1. Unidad de Evaluación, Agencia Sanitaria Costa del Sol, Marbella, Málaga, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Málaga, España. 2. Unidad de Documentación Médica, Hospital Universitario Virgen de la Victoria, Málaga, España. 3. Unidad de Urgencias, Agencia Sanitaria Costa del Sol, Marbella, Málaga, España. 4. Unidad de Urgencias, Hospital Universitario Virgen de la Victoria, Málaga, España. 5. Unidad de Documentación Médica, Agencia Sanitaria Costa del Sol, Marbella, Málaga, España.
Abstract
OBJECTIVES: The return-visit rate has been suggested as a measure of emergency department quality of care. We aimed to identify the reasons for emergency revisits and the percentage of returns related to problems with quality of care in the previous visit. MATERIAL AND METHODS: Cross-sectional observational study of clinical records for a random sample of unscheduled returns within 72 hours of discharge from the emergency departments of 3 hospitals attending a population of nearly 3 million in the Spanish province of Malaga. The records were reviewed by 2 data collectors, who assigned a reason for revisits according to a standardized classification. RESULTS: A sample of 1075 emergency revisits were reviewed; 895 met the inclusion criteria. The most common reasons for revisits were the persistence or progression of disease (48.8%), an unrelated new problem (9.3%), and referral from a hospital that did not have the required specialized service (8.6%). Reasons attributable to the patient accounted for 14.5% of the revisits; 15.2% were attributable to health care staff errors, 9.2% to system organization, and 61.1% to the disease process. CONCLUSION: Most emergency department revisits are related to the progression of the disease that led to the first visit. Only a small percentage can be linked to diagnostic or treatment errors in the previous visit.
OBJECTIVES: The return-visit rate has been suggested as a measure of emergency department quality of care. We aimed to identify the reasons for emergency revisits and the percentage of returns related to problems with quality of care in the previous visit. MATERIAL AND METHODS: Cross-sectional observational study of clinical records for a random sample of unscheduled returns within 72 hours of discharge from the emergency departments of 3 hospitals attending a population of nearly 3 million in the Spanish province of Malaga. The records were reviewed by 2 data collectors, who assigned a reason for revisits according to a standardized classification. RESULTS: A sample of 1075 emergency revisits were reviewed; 895 met the inclusion criteria. The most common reasons for revisits were the persistence or progression of disease (48.8%), an unrelated new problem (9.3%), and referral from a hospital that did not have the required specialized service (8.6%). Reasons attributable to the patient accounted for 14.5% of the revisits; 15.2% were attributable to health care staff errors, 9.2% to system organization, and 61.1% to the disease process. CONCLUSION: Most emergency department revisits are related to the progression of the disease that led to the first visit. Only a small percentage can be linked to diagnostic or treatment errors in the previous visit.
Entities:
Keywords:
Calidad asistencial; Emergency department; Health care quality; Investigación en Resultados de Salud; Outcome and process assessment; Retornoszzm321990no programados; Revisitas; Servicios de Urgencias; Unscheduled return visits