Characteristics of short-term re-presentations to a regional emergency department

Abstract

Objective: The present study aims to describe the characteristics of early ED re-presentations in a regional hospital in New South Wales, Australia.

Methods: This was a retrospective review of all patients re-presenting within 72 h of discharge from Coffs Harbour Base Hospital ED, a regional ED, for the 2016-2017 financial year. Presentations were categorised according to their diagnosis and cause for re-presentation.

Results: Of the 38 986 presentations to the ED within the study period, 2125 patients met re-presentation inclusion criteria (5.45%). Diagnoses most likely to re-present were injury/trauma (18.8%), gastrointestinal (14.8%) and psychiatric (12.5%). The most common cause for re-presentation was disease progression (32.7%). Patients aged over 66 were the most likely to be admitted on re-presentation (35.8%) followed by the 17-65 age group (24.2%) and the <16 age group (18.7%).

Conclusions: Re-presentations were common, but did not lead to increased admissions. The regional hospital in the present study had a higher 72 h ED re-presentation rate than the comparative major city hospital. In particular, paediatric and psychiatric re-presentations were a greater burden to the regional ED. This may be secondary to a lack of alternative services, particularly for these patient groups. Improving these outpatient services may help to reduce the burden of 72 h ED re-presentations.

Keywords: emergency department; frequent presenter; re-presentation; regional.