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International Journal of Emergency Medicine

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Open Access 01-12-2014 | Original Research

Rate, characteristics, and factors associated with high emergency department utilization

Authors: M Christien van der Linden, Crispijn L van den Brand, Naomi van der Linden, Anna HJH Rambach, Caro Brumsen

Published in: International Journal of Emergency Medicine | Issue 1/2014

Abstract

Background

Patients with high emergency department (ED) utilization account for a disproportionate number of ED visits. The existing research on high ED utilization has raised doubts about the homogeneity of the frequent ED user. Attention to differences among the subgroups of frequent visitors (FV) and highly frequent visitors (HFV) is necessary in order to plan more effective interventions.

In the Netherlands, the incidence of high ED utilization is unknown. The purpose of this study was to investigate if the well-documented international high ED utilization also exists in the Netherlands and if so, to characterize these patients. Therefore, we assessed the proportion of FV and HFV; compared age, sex, and visit outcomes between patients with high ED utilization and patients with single ED visits; and explored the factors associated with high ED utilization.

Methods

A 1-year retrospective descriptive correlational study was performed in two Dutch EDs, using thresholds of 7 to 17 visits for frequent ED use, and greater than or equal to 18 visits for highly frequent ED use.

Results

FV and HFV (together accounting for 0.5% of total ED patients) attended the ED 2,338 times (3.3% of the total number of ED visits). FV and HFV were equally likely to be male or female, were less likely to be self-referred, and they suffered from urgent complaints more often compared to patients with single visits. FV were significantly older than patients with single visits and more often admitted than patients with single visits. Several chief complaints were indicative for frequent and highly frequent ED use, such as shortness of breath and a psychiatric disorder.

Conclusions

Based on this study, high ED utilization in the Netherlands seems to be less a problem than outlined in international literature. No major differences were found between FV and HFV, they presented with the same, often serious, problems. Our study supports the notion that most patients with high ED utilization visit the ED for significant medical problems.

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Title: Rate, characteristics, and factors associated with high emergency department utilization
Authors: M Christien van der Linden
Crispijn L van den Brand
Naomi van der Linden
Anna HJH Rambach
Caro Brumsen
Publication date: 01-12-2014
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Emergency Medicine / Issue 1/2014
Print ISSN: 1865-1372
Electronic ISSN: 1865-1380
DOI: https://doi.org/10.1186/1865-1380-7-9

At a glance: The STEP trials

Springer Medicine

Rate, characteristics, and factors associated with high emergency department utilization

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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