Determinants and prevalence of paediatrics return visits to the emergency department in a tertiary hospital in southeast Nigeria: A retrospective study

Abstract

Background: Pediatric Emergency Department (ED) return visits are an essential quality indicator, assessing the
adequacy of care provided during the initial consultation, patient management, and subsequent follow-up. Despite
the high burden of pediatric emergency cases, there is paucity of data on the prevalence and determinants of return
visits in Nigeria. This study therefore aims to determine the prevalence and determinants of pediatric return visits
to the ED in a tertiary hospital in Southeast Nigeria.
Methods: A retrospective review of medical records was conducted for pediatric patients who visited the ED of the
National Obstetric Fistula Center (NOFIC) Abakaliki Ebonyi State, from September 2022 to August 2023. Data on
demographics, presenting complaints, diagnoses, investigations, and treatments from initial and return visits were
collected and analyzed. Statistical analyses were performed to determine the prevalence of return visits and explore
associations with factors such as age, sex, type of caregiver, number of diagnoses, and duration of admission.
Results: Among 181 pediatric patients, 19 (10.5%) had a return visit to the ED. Most of these patients were 0-5
years old (80.7%), with a slightly higher proportion of males (56.9%). The most reported symptoms were fever
(77.3%) and vomiting (44.8%), with malaria being the predominant diagnosis at both initial (65 cases) and return
visits. Although male children (68.4%) and those with multiple diagnoses had higher return rates, statistical
analysis revealed no significant associations between return visits and the examined variables.
Conclusion: The 10.5% prevalence of pediatric return visits to the ED is a clear indicator of the complex
relationship between illness severity, the quality of care provided and the health-seeking behavior of care givers in
a resource limited health care facility. The study helps to understand some causes of return visits and develop
strategies to reduce their occurrence.