Premature Departure From the Pediatric Emergency Department

• DOI: 10.1097/pec.0b013e3181db2042
• Publication Date: 2010-04-17T08:04:42Z
• Authors: Keith P. Cross; Veronica H. Cammack; Aaron W. Calhoun; Edward J. Gracely; In K. Kim; Michelle D. Steve...; Charles R. Woods
• Keywords: Patient Transfer; Patient Dropouts; Time Factors; 1. No poverty; Hospitals, Pediatric; Intensive Care Units, Pediatric; Severity of Illness Index; Health Services Accessibility; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Humans; Triage; Child; Emergency Service, Hospital; Follow-Up Studies; Retrospective Studies

Previous literature suggests that process-related factors (eg, time of day, patient volume) and patient-related acuity, socioeconomic status) are associated with premature departure from emergency departments. We sought to evaluate the relationship these other in a large, unselected cohort pediatric department patients.This study was retrospective analysis visits single tertiary site during 1-year period. Patients' zip codes determined assignment census-based metrics. Multivariate regression identified departure. Sensitivity subset analyses were performed. Return within 48 hours after also reviewed.There 46,417 visits, which 2164 departures. In multivariate analysis, independent predictors departures arrival time, month, day week, concurrent departures, rate, period average length stay, poverty rate. Aside acuity no significant analysis. These results robust sensitivity across different models. Among there 120 return (5.5%), 15 admitted (0.7%). There deaths. Acuity similar between initial subsequent visits.Process-related individual have strongest influence on department. Health care organizations concerned should focus efforts improving process flow.