Factors Affecting 72-Hour Unplanned Return Visits after Emergency Department Index Discharge of a Tertiary Private Hospital in the Philippines

Abstract

Objectives. This study aimed to analyze if the indicator 72-hours Unplanned Return Visits after Emergency
Department (ED) index discharge was influenced by the patient’s age, triage severity, month, payment methods,
and length of stay. Likewise, it aimed to determine if the 72-hour Unplanned Return Visits was a robust indicator in
assessing the quality of Emergency Department services.

Methods. This was a retrospective single-center study from January to December 2017. Data were retrieved
from a tertiary hospital in the Philippines. All Emergency Department patients discharged on their index visit
were monitored for Unplanned Return Visits within 72 hours in the hospital. A univariate and multivariate logistic
regression model was used to assess the variables associated with the 72-hour Unplanned Return Visits.

Results. The 72-hour Unplanned Return Visits rate was measured at 2.67%, with the highest occurrence on the
first 24 hours, and with predominance on third-party payer (p.<.0001), pediatrics (p.<0001), January (p<.0001),
February (p<.0001), November (p<.0001), December (p<0001), and shorter length of stay (p<.0001) discharged
after ED index visit.

Conclusions. Strong association of Unplanned Return Visits during the first 72 hours after Emergency Department
index discharge was found for patients financed through third party-payers, with seasonal variations and
inclination to the younger population with shorter length of stay. These findings warrant exploratory studies to
determine the reasons for the 72-hour Unplanned Return Visits after Emergency Department index discharge and
investigation on the association of premature discharge, socio-economic, health structure, and illness progression.