Repeat pediatric visits to a general emergency department.
OBJECTIVE
To determine the rate of repeat visits among children cared for in a general emergency department and associated demographic and clinical variables.


METHODS
We carried out a chart review of patients seen in the ED of a general hospital serving both inner-city and suburban populations. Our subjects were all children younger than 18 years seen in the study ED between July 1, 1992, and June 30, 1993 (N = 4,276).


RESULTS
We found 291 repeat visits (defined as a subsequent visit within 14 days) n 245 children. Among the 242 repeat visits for related complaints, 200 were unanticipated and most without a clear medical need. Mantel-Haenszel adjusted odds ratios (MHORs) showed a significantly increased risk of repeat visit with public insurance (controlled for age: MHOR, 2.57, and 95% confidence interval [CI], 1.93 to 3.43; controlled for race: MHOR, 2.70, and 95% CI, 1.99 to 3.66) and age younger than 2 years (controlled for insurance MHOR, 1.67, and 95% CI, 1.27 to 2.19; controlled for race: MHOR, 1.89, and 95% CI, 1.47 to 2.47.


CONCLUSIONS
Repeat visits were more likely for respiratory diagnoses and less likely for minor trauma. Both visits and repeat visits were more likely in patients from poorer census tracts than in those from equidistant, more affluent ones.
Department of Pediatrics, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, USA.
D R
DR
Zimmerman
K A
KA
McCarten-Gibbs
D H
DH
DeNoble
C
C
Borger
J
J
Fleming
M
M
Hsieh
J C
JC
Langer
M B
MB
Breckenridge
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D003951:Diagnostic Errors; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005006:Ethnicity; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D017057:Medically Uninsured; D016017:Odds Ratio; D010372:Pediatrics / Q000706:statistics & numerical data*; D011632:Public Assistance; D012008:Recurrence; D012959:Socioeconomic Factors