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Emergency Medicine International - Volume 2016 2016, Article ID 8983573, 5 pages -

Research Article

Emergency Department, Massachusetts General Hospital, Five Emerson, Suite 155, Boston, MA 02114, USA

Emergency Department, Vajira Hospital, Navamindradhiraj University, 681 Samsen Road, Dusit District, Bangkok 10300, Thailand

Emergency Department, Massachusetts General Hospital, 55 Fruit Street, Zero Emerson Place, Room 346, Boston, MA 02114, USA

Received 8 March 2016; Revised 2 June 2016; Accepted 19 June 2016

Academic Editor: Chak W. Kam

Copyright © 2016 Jiraporn Sri-on et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. Emergency department ED revisits are a common ED quality measure. This study was undertaken to ascertain the contributing factors of revisits within 48 hours to a Thai ED and to explore physician-related, illness-related, and patient-related factors behind those revisits. Methods. This study was a chart review from one tertiary care, urban Thai hospital from October 1, 2009, to September 31, 2010. We identified patients who returned to the ED within 48 hours for the same or related complaints after their initial discharge. Three physicians classified revisit as physician-related, illness-related, and patient-related factors. Results. Our study included 172 ED patients’ charts. 86-172 50% were male and the mean age was SD years. The ED revisits contributing factors were physician-related factors 86-172 50.0%, illness-related factors 61-172 35.5%, and patient-related factor 25-172 14.5%, respectively. Among revisits classified as physician-related factors, 40-86 46.5% revisits were due to misdiagnosis and 36-86 41.9% were due to suboptimal management. Abdominal pain 27-86 31.4% was the majority of physician-related chief complaints, followed by fever 16-86 18.6% and dyspnea 15-86 17.4%. Conclusion. Misdiagnosis and suboptimal management contributed to half of the 48-hour repeat ED visits in this Thai hospital.

Autor: Jiraporn Sri-on, Adisak Nithimathachoke, Gregory Philip Tirrell, Sataporn Surawongwattana, and Shan Woo Liu



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