Factors Influencing Pediatric Emergency Department Return Visits in a Nigerian Tertiary Hospital: A Retrospective Analysis

Abstract

Background: Pediatric return visits to the emergency department (ED) are key indicators of healthcare quality and system efficiency. Understanding the factors that contribute to these return visits is essential to improving patient outcomes and optimising emergency care delivery in resource-limited settings. Pediatric emergency departments (PEDs) serve as critical points of contact for children requiring urgent care. Objective: This study aimed to determine the prevalence and identify the determinants of pediatric return visits to the ED in a tertiary hospital in Southeast Nigeria. Methods: A retrospective review of pediatric patients who presented to the Children’s Emergency Department between January 2022 and December 2023 was conducted. Data extracted from hospital records included demographic characteristics, presenting complaints, initial diagnoses, investigations, treatments administered, and outcomes. Return visits were defined as unplanned revisits occurring within 72 hours of discharge. Statistical analysis was performed using descriptive and inferential statistics to determine the prevalence and associations between patient characteristics and return visits. Results: A total of 650 pediatric cases were reviewed. The majority of patients (80.7%) were aged 0–5 years, with males accounting for 56.9% of visits. Most children (94%) were cared for by their mothers. The prevalence of return visits within 72 hours was 11%. Common complaints at the first visit included fever, respiratory distress, and diarrhoea. No significant associations were found between demographic variables, initial diagnosis, or treatment type and the likelihood of a return visit (p > 0.05). However, inadequate caregiver understanding of discharge instructions and incomplete resolution of symptoms were observed in several revisits. Conclusion: The prevalence of pediatric return visits to the ED in this tertiary hospital is relatively low but remains a relevant indicator of care quality. Strengthening caregiver education, improving discharge communication, and ensuring adequate follow-up could reduce unnecessary return visits and enhance pediatric emergency care outcomes in low-resource settings.