研究背景：醫療品質指標為醫療品質評估之重要依據，基於急診病患日益增多與疾病複雜性之特性，醫療品質之提升更是有其迫切性。本研究主要目的在探討兒科急診非計畫性重返與返診後再住院的臨床特性與相關因素。方法:本研究採橫斷式研究法，以南部某醫學中心九十五年4-6月至兒科急診，非計畫性72小時內重返急診之個案(排除新問題)為對象，統計分析重返個案之基本資料、個案就醫診斷、就診時段與停留時間、重返原因及重返後動向、重返問隔時間等因素。研究結果：研究期間內兒科急診72小時內重返急診人數為530人，共造成565次重返，重返率為6.19%。病患平均年齡3.45(± 2.95)歲，當中以「0-24小時內重返」之個案居多佔60.4%，重返原因則發現以症狀未改善居多，佔91.3%，重返個案最常見的診斷為「急性呼吸道感染」佔46.9%，「發燒」佔7.4%；重返急診後住院者，比率高達64.1%，返診後是否再住院與性別、年齡及診斷無關，發現第一次急診停留時間越久與24小時內重返者則有較高返診後再住院比率(p< .05)。 結論：本研究發現兒科急診重返率與重返後再住院率，高於整體重返急診指標，以年齡較小之兒童因呼吸道感染的症狀末在短期間改善為主，針對這種使用特性需要進一步研究設計可行方案以改善兒科急診重返狀況。

Background: Medical quality indicator is an important measurement tool for healthcare improvement. The objective of this study is to investigate the clinical characteristics and factors associated with 72-hour unscheduled revisits to the pediatric emergency department (PED). Materials and Methods: We conducted retrospective cross-sectional study of 72-hour unscheduled revisits to PED of medical center in southern Taiwan from April 2006 to June 2006. Clinical characteristics including demographic data, diagnosis, timing and duration of first visit to PED as well as time interval between the revisits were collected and analyzed. Result: During the study period, there were 530 patients returned to PED within 72 hours accounting for 565 revisits and the revisit rate was 6.19% The Mean age of patients was 3.45±2.95 year old. The most common diagnosis were acute respiratory infection (46.9%) and fever (7.4%). The most common reason for revisits was the clinical symptoms not relived (71%) and majority of patients revisited within 24 hours(60.4%). The admission rate after revisits was 64.1% and was not related to sex, age and diagnosis. However, the admission rate was independently associated with longer length of ED stay and shorter revisit time interval. Conclusion: 72-hour unscheduled revisits rate of PED patients and its readmission rate were high. Children will younger age suffered from respiratory tract infection who symptom could not be relieved will short duration are on greater risk for revisits.