title: A Survey of Return Visits to the Pediatric Emergency Department: The Caretakers' Perspective.
abstract: OBJECTIVE
  Approximately 5% of children return to the emergency department within 72 hours of a first evaluation. Previous literature has focused on healthcare utilization and the use of return visits as a quality metric. The goal of this study was to quantify reasons for return visits from the caretaker perspective.
  
  
  METHODS
  Caretaker surveys were developed based on previously identified themes from focus groups. When considering reasons for return, multiple answers were allowed. Surveys were administered to a convenience sample of eligible caretakers who returned to the emergency department within 72 hours between June and August 2013. Caretakers were excluded if the return was scheduled or for an unrelated complaint.
  
  
  RESULTS
  Of the 306 eligible caretakers, 83 (27%) participated. A majority returned because of continued (92%) or worsening symptoms (70%). More than half returned because they did not know how to help their child at home (60%), they did not understand their child's illness (59%), and/or they did not expect the persistence of symptoms (58%). Overall, caretakers felt more testing (55%), treatments (45%), medications (41%), and information (28%) should have been provided at the initial visit. Caretakers of children admitted at the second visit were significantly more dissatisfied with care at the first visit (P = 0.05).
  
  
  CONCLUSIONS
  The most commonly reported reasons for pediatric return visits were continued symptoms and lack of illness understanding. We plan to use these data to develop targeted interventions to decrease the perceived need for return visits.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Augustine
authors.forename: Tatiana D
authors.initials: TD
authors.lastname: Bekker
authors.forename: Ansha
authors.initials: A
authors.lastname: Goel
authors.forename: Kristen A
authors.initials: KA
authors.lastname: Breslin
authors.forename: James M
authors.initials: JM
authors.lastname: Chamberlain
mesh_terms: D000293:Adolescent; D017028:Caregivers / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D017144:Focus Groups; D006801:Humans; D007223:Infant; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires