Re-attenders to the emergency department of a major urban hospital serving a population of 290,000.

Abstract

The national Emergency Medicine Programme (EMP) in Ireland, defines a re-attender as any patient re-presenting to the Emergency Department (ED) within 28 days with the same chief complaint. A retrospective, electronic patient record audit was carried out on all re-attenders to Connolly ED during November 2012. There were 2919 attendances made up from 2530 patients; 230 patients re-attended a total of 389 times. The re-attendance rate was 13% (389/2919). 63 (27%) were frequent presenters. There was a significantly higher admission rate at second attendance than first (89 (39%) vs 39 (17%), p < 0.001). 25% (57/230) of patients 'left before completion of treatment' (LBCT) at first attendance (significantly higher than the number at second attendance (p < 0.01)). 14/57 (25%) of those who LBCT at first attendance required admission at second attendance. 28/89 (31%) of second attendance admissions were failed discharges from first attendance. Reasons for re-attendance are multi-factorial and include both patient and departmental factors.