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Publication Details

Title :

Emergency department 72-hour revisits among children with chronic diseases: a Saudi Arabian study

Journal:

BMC Pediatrics

Impact Factor:

2.071

Authors:

Ahmed AE1,2,3, ALMuqbil BI4, Alrajhi MN4, Almazroa HR4, AlBuraikan DA4, Albaijan MA5, Nasim M5, Alsalamah MA4, McClish DK6, Al-Jahdali H7,8,9.

Affiliations:

1 King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia. ahmeda5@vcu.edu.

2 King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, P.O. Box 22490, Riyadh, 11426, Saudi Arabia. ahmeda5@vcu.edu.

3 Pulmonary Division Medical Director of sleep disorders, Center King Abdulaziz Medical City, Riyadh, Saudi Arabia. ahmeda5@vcu.edu.

4 King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, P.O. Box 22490, Riyadh, 11426, Saudi Arabia.

5 King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia.

6 Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Box 980032, Richmond, VA, 23298, USA.

7 King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, P.O. Box 22490, Riyadh, 11426, Saudi Arabia. jahdalih@gmail.com.

8 McGill University, Montreal, Canada. jahdalih@gmail.com.

9 Pulmonary Division Medical Director of sleep disorders, Center King Abdulaziz Medical City, Riyadh, Saudi Arabia. jahdalih@gmail.com.

Year of Publication:

2018

DOI:

10.1186/s12887-018-1186-8

Abstract:

BACKGROUND:
Emergency Department (ED) revisits have often been used as an indicator of medical care quality. This study aimed to quantify the frequency of ED revisits within 72 h of discharge and identify its factors among children with chronic diseases.

METHODS:
We designed a retrospective cohort study of children with at least one chronic disease who were also under 18 years of age and had attended and were discharged from the ED at King Abdullah Specialist Children’s Hospital (KASCH-RD), Riyadh, Saudi Arabia between April 19, 2015 and July 29, 2017. The outcome measure was the frequency of ED revisits during a period of 72 h after discharge.

RESULTS:
The study included 11,057 ED discharges of children with at least one chronic disease. Their revisit rate was 1211 (11%), with 83 (6.9%) having had a second ED revisit within 72 h of ED discharge. According to ICD-10 codes, the most common causes of ED revisits were respiratory, digestive, genitourinary, symptoms, and external causes. Factors of frequent ED revisits within 72 h were young age, institutional health insurance coverage, year of new health information system (2015), external causes, and genitourinary.

CONCLUSIONS:
The rate of 72-h ED revisits after discharge of children with chronic diseases treated at KASCH-RD was relatively high, and was associated with young age, institutional health insurance coverage, year of a new health information system implementation, and external causes of ED visit. These study findings amplify the need for intervention to reduce the rate of early ED revisits among children with chronic diseases.