Revisits within 48 Hours to a Thai Emergency Department

Objective. Emergency department (ED) revisits are a common ED quality measure. This study was undertaken to ascertain the contributing factors of revisits within 48 hours to a Thai ED and to explore physician-related, illness-related, and patient-related factors behind those revisits. Methods. This...

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Main Authors: Jiraporn Sri-on, Adisak Nithimathachoke, Gregory Philip Tirrell, Sataporn Surawongwattana, Shan Woo Liu
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Emergency Medicine International
Online Access:http://dx.doi.org/10.1155/2016/8983573
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author Jiraporn Sri-on
Adisak Nithimathachoke
Gregory Philip Tirrell
Sataporn Surawongwattana
Shan Woo Liu
author_facet Jiraporn Sri-on
Adisak Nithimathachoke
Gregory Philip Tirrell
Sataporn Surawongwattana
Shan Woo Liu
author_sort Jiraporn Sri-on
collection DOAJ
description Objective. Emergency department (ED) revisits are a common ED quality measure. This study was undertaken to ascertain the contributing factors of revisits within 48 hours to a Thai ED and to explore physician-related, illness-related, and patient-related factors behind those revisits. Methods. This study was a chart review from one tertiary care, urban Thai hospital from October 1, 2009, to September 31, 2010. We identified patients who returned to the ED within 48 hours for the same or related complaints after their initial discharge. Three physicians classified revisit as physician-related, illness-related, and patient-related factors. Results. Our study included 172 ED patients’ charts. 86/172 (50%) were male and the mean age was 38 ± 5.6 (SD) years. The ED revisits contributing factors were physician-related factors [86/172 (50.0%)], illness-related factors [61/172 (35.5%)], and patient-related factor [25/172 (14.5%)], respectively. Among revisits classified as physician-related factors, 40/86 (46.5%) revisits were due to misdiagnosis and 36/86 (41.9%) were due to suboptimal management. Abdominal pain [27/86 (31.4%)] was the majority of physician-related chief complaints, followed by fever [16/86 (18.6%)] and dyspnea [15/86 (17.4%)]. Conclusion. Misdiagnosis and suboptimal management contributed to half of the 48-hour repeat ED visits in this Thai hospital.
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spelling doaj-art-dee1fe0c6e6b4164806f6d180a3cc7cf2025-08-20T02:21:06ZengWileyEmergency Medicine International2090-28402090-28592016-01-01201610.1155/2016/89835738983573Revisits within 48 Hours to a Thai Emergency DepartmentJiraporn Sri-on0Adisak Nithimathachoke1Gregory Philip Tirrell2Sataporn Surawongwattana3Shan Woo Liu4Emergency Department, Massachusetts General Hospital, Five Emerson, Suite 155, Boston, MA 02114, USAEmergency Department, Vajira Hospital, Navamindradhiraj University, 681 Samsen Road, Dusit District, Bangkok 10300, ThailandEmergency Department, Massachusetts General Hospital, Five Emerson, Suite 155, Boston, MA 02114, USAEmergency Department, Vajira Hospital, Navamindradhiraj University, 681 Samsen Road, Dusit District, Bangkok 10300, ThailandEmergency Department, Massachusetts General Hospital, 55 Fruit Street, Zero Emerson Place, Room 346, Boston, MA 02114, USAObjective. Emergency department (ED) revisits are a common ED quality measure. This study was undertaken to ascertain the contributing factors of revisits within 48 hours to a Thai ED and to explore physician-related, illness-related, and patient-related factors behind those revisits. Methods. This study was a chart review from one tertiary care, urban Thai hospital from October 1, 2009, to September 31, 2010. We identified patients who returned to the ED within 48 hours for the same or related complaints after their initial discharge. Three physicians classified revisit as physician-related, illness-related, and patient-related factors. Results. Our study included 172 ED patients’ charts. 86/172 (50%) were male and the mean age was 38 ± 5.6 (SD) years. The ED revisits contributing factors were physician-related factors [86/172 (50.0%)], illness-related factors [61/172 (35.5%)], and patient-related factor [25/172 (14.5%)], respectively. Among revisits classified as physician-related factors, 40/86 (46.5%) revisits were due to misdiagnosis and 36/86 (41.9%) were due to suboptimal management. Abdominal pain [27/86 (31.4%)] was the majority of physician-related chief complaints, followed by fever [16/86 (18.6%)] and dyspnea [15/86 (17.4%)]. Conclusion. Misdiagnosis and suboptimal management contributed to half of the 48-hour repeat ED visits in this Thai hospital.http://dx.doi.org/10.1155/2016/8983573
spellingShingle Jiraporn Sri-on
Adisak Nithimathachoke
Gregory Philip Tirrell
Sataporn Surawongwattana
Shan Woo Liu
Revisits within 48 Hours to a Thai Emergency Department
Emergency Medicine International
title Revisits within 48 Hours to a Thai Emergency Department
title_full Revisits within 48 Hours to a Thai Emergency Department
title_fullStr Revisits within 48 Hours to a Thai Emergency Department
title_full_unstemmed Revisits within 48 Hours to a Thai Emergency Department
title_short Revisits within 48 Hours to a Thai Emergency Department
title_sort revisits within 48 hours to a thai emergency department
url http://dx.doi.org/10.1155/2016/8983573
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