Factors Affecting Return Visits to the Emergency Department within 30 Days

Background and Objectives: The goal of this study is to determine the factors associated with the admission to hospital on a return visit to the ED. The reasons of return visits to the ED are complex and involve such causes as disease progression, medical errors, delayed diagnosis, or misdiagnosis. Materials and methods: A retrospective study was conducted in Vilnius University Hospital Santaros Klinikos. All the emergency visits from 1 January 2018 through 20 May 2019 were included. The patients were divided into two groups: the patients who visited the ED only once within a month were attributed to group 1, while those who paid two or more visits to the ED within 30 days belonged to group 2. The demographic data, the triage category, the number of laboratory and radiology tests, specialist consultations, diagnoses and the time spent in the ED were evaluated. The statistical analysis was performed using R statistical software package, non-parametric statistical methods were used. Results: 32,215 patients were included in the analysis, 3,243 patients (10.05%of all the initial visits) returned to the ED within 30 days. The number of laboratory tests had a statistically significant impact on admission to the ward both the first and the return visits. The triage category was associated with the admission on the return visit to the ED. Age, gender, number of consultations and radiology tests had no medium or large impact. Among the diagnoses, cardiovascular, gastrointestinal and renal diseases were related to the admission on return visit. Conclusions: Patients with cardiovascular, gastrointestinal and renal system diseases in all age groups, patients with medical conditions and advanced investigation (the increased number of laboratory testing and the time spent in the ED) have an increased risk for a return visit over a 30-day time frame and an increased rate of hospital admissions.