Aušra Bilotienė–Motiejūnienė, Andrius Klimašauskas, Eglė Kontrimavičiūtė, Rūta Janulevičienė, Dovilė Majauskytė, Rimantas Stukas
The rate of attendance at the Emergency Department (ED) is annually increasing worldwide. Return visits constitute 5% of all visits to the ED. The aim of this review is to determine the incidence and reasons of the readmissions to the ED as well as to provide possible solutions in order to avoid unscheduled return visits. Therefore, literature review was conducted using the databases of Medline, PubMed, Cinahl and Cochrane (from inception to September, 2019). Various keywords were used in the advanced search: return visits, unscheduled returns, revisits, unplanned return visits, readmission. Approximately 40 articles that met the inclusion criteria were selected for this paper. Various time frames – 48 hours, 72 hours, 7 days, 30 days, 180 days ‒ were applied for the evaluation of return visits. Unplanned return visits (URV) are more likely to happen in elderly patients, in those who have the underlying disease and in younger children aged less than six years. The main causes of the return visits are the factors related to the patients or to the physicians (disease progression, medical errors, delayed diagnosis, or misdiagnosis). The highest return rates according to the medical conditions have been recorded for the abdominal pain, urinary tract infections, and migraine. Hospitalized patients constitute up to 40% of returning patient cases. There is no consensus on the term or time frame employed to classify the return visits to the ED. Most commonly used readmission time frames reveal the evidence regarding the factors related to patients, illnesses, and staff. The future researches should focus on patient education, clinicians and healthcare providers in order to facilitate the creation of predictive models for reduction of unplanned readmissions. These proceedings will significantly reduce the expenses, both personnel resources and institutional costs.