Reattendance audit in an inner-city emergency department

Abstract

A study was carried out in an inner-city emergency department (ED) of patients returning for related complaints within 48 h of discharge. The incidence was around 0.7% and the majority (82%) of patients presented with persistence or progression of the original symptoms. Patient-related factors accounted for 13% of returns and only 5% were found to be the result of doctor-related factors. Of the returnees, 54% were discharged and 36% were admitted. The most common initial complaint was pain (31%) which, in 23% of patients, was localized to the abdomen. Injury (14%) and febrile illnesses (13%) came second and third. Asthma and chronic obstructive airway diseases (COAD) also accounted for 8% of cases. Children of less than 10 years of age were more likely to return within 48 h. About 18% of cases were thought to be potentially avoidable. Better patient education and an improvement in primary health care services were thought to be important in decreasing such avoidable reattendance. Reattendance audit was a useful tool in the continuous quality improvement programme of emergency department.