Characterizing 72-Hour Return Visits to the Emergency Department
A retrospective study of 155 patients who came back to a tertiary emergency department within three days of being sent home — and what that says about how we discharge people.
- Sample size
- 155 records
- Study period
- January 2023 — December 2024
- Institution
- Dr. L. H. Hiranandani Hospital
- Awarded by
- Society of Emergency Medicine, India
Three numbers that carry the argument
of return visits were preventable
Patient-related and physician-related causes together accounted for 29.04% of all 72-hour returns — nearly one in three, and every one of them addressable through better systems rather than better medicine.
age predicts why people come back
The reason for returning varied significantly by age group, which argues for discharge advice tailored to the patient in front of you rather than a single generic instruction sheet.
were working-age adults
The 30–49 band dominated return visits, a group who tend to defer care, self-discharge early, and return once symptoms interfere with work.
Causes of return visits
Disease-related recurrence and progression accounted for the majority. But 29% traced back to communication and decision-making — the part the system controls.
- Disease-related recurrence37.42%
The original condition recurred after discharge.
- Disease progression33.55%
The underlying illness advanced despite appropriate initial care.
- Patient-related factors20.65%
Discharge instructions not followed or not understood — the largest genuinely preventable share.
- Physician-related factors8.39%
Premature discharge or incomplete initial assessment.
Distribution by age
Working-age adults dominated. The relationship between age group and reason for returning was statistically significant (p = 0.0021).
- 0–179.03%
- 18–2916.13%
- 30–4943.23%
- 50–6920.00%
- 70+11.61%
The study in full
- Qualification
- Certificate of Completion of Training in Emergency Medicine (CCT-EM)
- Training period
- September 2022 — September 2025
- Guide
- Dr. Samrat Chavan — Head of Department & Consultant in Emergency Medicine
Approvals
- Institutional Ethics Committee
- Scientific Committee
PDF · 2.6 MB · Society of Emergency Medicine, India
Characterizing 72-Hour Return Visits to the Emergency Department: A Retrospective Study
Background
Emergency Department revisits within 72 hours of discharge are increasingly recognised as key indicators of care quality, patient safety and healthcare system performance. This retrospective study characterises the nature, causes and contributing factors associated with 72-hour return visits to a tertiary care hospital's emergency department.
Methods
A retrospective review of 155 patient records from January 2023 to December 2024. Data were collected on demographic characteristics, primary complaints, revisit timings and reasons for revisit. Statistical analysis, including chi-square tests, assessed associations between revisit causes and variables such as age, gender and year of admission.
Results
Of the 155 return visits, the most common causes were disease-related recurrence (37.42%) and disease progression (33.55%). Patient-related factors, including failure to follow or understand discharge instructions, accounted for 20.65% of revisits, while physician-related causes such as premature discharge represented 8.39%. The 30–49 age group showed the highest frequency of revisits (43.23%). No significant associations were found between gender or year of admission and revisit cause; however, a statistically significant relationship (p = 0.0021) was observed between age group and reason for revisit.
Conclusion
While many emergency department revisits are due to unavoidable disease-related factors, a substantial proportion can be prevented through better discharge planning, enhanced patient education and systematic follow-up care. Interventions tailored by age group and improved interprofessional communication are essential for minimising avoidable returns and improving overall healthcare outcomes.