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Pediatr Emerg Care. 2015 Dec;31(12):819-24. doi: 10.1097/PEC.0000000000000417.

Predicting Factors and Risk Stratification for Return Visits to the Emergency Department Within 72 Hours in Pediatric Patients.

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From the *Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City; †Department of Economics, National Chung Cheng University, Chiayi County; ‡Departments of Pediatrics and Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City; §Department of Information Management and Institute of Healthcare Information Management, National Chung Cheng University, Chiayi County; and ∥Information Technology Office, Taipei City Hospital, Taipei, Taiwan.



A return visit (RV) to the emergency department (ED) is usually used as a quality indicator for EDs. A thorough comprehension of factors affecting RVs is beneficial to enhancing the quality of emergency care. We performed this study to identify pediatric patients at high risk of RVs using readily available characteristics during an ED visit.


We retrospectively collected data of pediatric patients visiting 6 branches of an urban hospital during 2007. Potential variables were analyzed using a multivariable logistic regression analysis to determine factors associated with RVs and a classification and regression tree technique to identify high-risk groups.


Of the 35,435 visits from which patients were discharged home, 2291 (6.47%) visits incurred an RV within 72 hours. On multivariable analysis, younger age, weekday visits, diagnoses belonging to the category of symptoms, signs, and ill-defined conditions, and being seen by a female physician were associated with a higher probability of RVs. Children younger than 6.5 years who visited on weekdays or between midnight and 8:00 AM on weekends or holidays had the highest probability of returning to the ED within 72 hours.


Our study reexamined several important factors that could affect RVs of pediatric patients to the ED and identified high-risk groups of RVs. Further intervention studies or qualitative research could be targeted on these at-risk groups.

[Indexed for MEDLINE]

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