Repeat pediatric visits to a general emergency department

Study objective: To determine the rate of repeat visits among children cared for in a general emergency department and associated demographic and clinical variables. Methods: We carried out a chart review of patients seen in the ED of a general hospital serving both inner-city and suburban populations. Our subjects were all children younger than 18 years seen in the study ED between July 1, 1992, and June 30, 1993 (N=4,276). Results: We found 291 repeat visits (defined as a subsequent visit within 14 days) in 245 children. Among the 242 repeat visits for related complaints, 200 were unanticipated and most without a clear medical need. Mantel-Haenszel adjusted odds ratios (MHORs) showed a significantly increased risk of repeat visit with public insurance (controlled for age: MHOR, 2.57, and 95% confidence interval [CI], 1.93 to 3.43; controlled for race: MHOR, 2.70, and 95% CI, 1.99 to 3.66) and age younger than 2 years (controlled for insurance: MHOR, 1.67, and 95% CI, 1.27 to 2.19; controlled for race: MHOR, 1.89, and 95% CI, 1.47 to 2.47). Conclusion: Repeat visits were more likely for respiratory diagnoses and less likely for minor trauma. Both visits and repeat visits were more likely in patients from poorer census tracts than in those from equidistant, more affluent ones.