Understanding the characteristics of recurrent visits to the emergency department by paediatric patients: a retrospective observational study conducted at three tertiary hospitals in Korea

Abstract

Objectives The number of paediatric patients visiting the emergency department (ED) continues to rise. In South Korea, approximately 25% of the patients who visit the ED are paediatric patients. In the USA, about 20% of the paediatric population were found to have visited the ED in the past year. A recent study demonstrated that 4.5%-8% of patients account for 25% of all ED visits. Therefore, the aim of this study was to identify the characteristics of recurrent visits. Methods Design: retrospective observational study. Setting: this study examined and analysed medical record data involving three tertiary EDs. Participants: a total of 46 237 ED visits by patients <16 years during 1-year period. Main outcome measures: data collected included the number of recurrent ED patients, frequency of recurrent visits, age, sex, insurance status, period until recurrent visit (days), main diagnosis and ED discharge results. Results Excluding patients with multiple visits, the total number of paediatric patients who fit the study criteria was 33 765. Among these patients, 23 384 (69.2%) had no recurrent ED visits in the subsequent year after their first visit. A total of 15 849 (46.8%) patients were toddlers (between age 1 and 4 years). In the patient group without a recurrent visit, fever was the most common diagnosis. Conclusions Our study reviewed medical records to inspect the characteristics of patients who return to care. Higher recurrent visit frequency was associated with using the 119 rescue centre service, having a medical condition, with younger age and a higher rate of hospitalisation. Analysis of the factors associated with frequent ED visits will help to improve care for paediatric patients who visit the ED.