title: Characteristics of patients and families who make early return visits to the pediatric emergency department.
abstract: OBJECTIVE
  The primary objective of this study was to identify reasons why parents make early return visits, within 72 hours of discharge from a tertiary care pediatric emergency department (PED). A secondary objective was to investigate associated demographic and diagnostic variables.
  
  
  METHODS
  A survey was conducted with a convenience sample of parents of children returning to the PED within 72 hours of discharge. A chart review was also completed for consented survey participants. Recruitment occurred from September 2005 to August 2006 at the Stollery Children's Hospital, Edmonton, Alberta, Canada.
  
  
  RESULTS
  A total of 264 parents were approached to participate. Overall, 231 surveys were returned and 212 (92%) charts were reviewed. The overall rate of early return during the study period was 5.4%. More than half of parents stated that they returned because their child's condition worsened and many parents (66.7%) reported feeling stressed. Patients were typically under 6 years of age (67.4%), and most frequently diagnosed with infectious diseases (38.0%). Patients triaged with the Canadian Emergency Department Triage and Acuity Scale (CTAS) as CTAS 2 (emergent) for initial visits were more likely to be admitted on return, regardless of age (P < 0.001).
  
  
  CONCLUSIONS
  Variables associated with early returns included young age, diagnosis, triage acuity, and parental stress. Future variable definition should include a deeper exploration of modifiable factors such as parental stress and patient education. These next steps may help direct interventions and resources to address needs in this group and possibly pre-empt the need to return.
authors.affiliation: Alberta Health Services, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Erin Patricia
authors.initials: EP
authors.lastname: Logue
authors.affiliation: Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Samina
authors.initials: S
authors.lastname: Ali
authors.affiliation: Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Judith
authors.initials: J
authors.lastname: Spiers
authors.affiliation: Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Amanda S
authors.initials: AS
authors.lastname: Newton
authors.affiliation: Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Janice A
authors.initials: JA
authors.lastname: Lander
keywords: accident and emergency; bounceback; pediatric; recidivism; survey