Differences in Clinical Characteristics and Utilization of Emergency Department by High-Frequency Users.
emergency service
health services needs and demand
Journal
The Journal of emergency medicine
ISSN: 0736-4679
Titre abrégé: J Emerg Med
Pays: United States
ID NLM: 8412174
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
15
10
2019
revised:
01
03
2020
accepted:
18
03
2020
pubmed:
1
5
2020
medline:
24
6
2021
entrez:
1
5
2020
Statut:
ppublish
Résumé
Knowing the distinctive features of patients with the highest utilization of the emergency department (ED) is paramount to finding adequate alternatives to ED care for selected patients and improving health care quality and efficiency. This study aimed to identify ED high-frequency users and compare their clinical and utilization characteristics with other ED users. Secondary data analysis of ED visits and patients database from a Portuguese public urban hospital. Retrospective study of adults visiting the ED in 2016 (61,403 patients; 95,643 visits), comparing demographic and clinical characteristics of patients and clinical and temporal characteristics of ED visits between high-frequency users (>10 ED visits in 2016) and frequent (4-10 ED visits) and nonfrequent (1-3 ED visits) users. We identified 169 high-frequency users (0.3% of patients and 3.0% of ED visits) with an average number of 16.9 visits in 2016. Patients in this group were older (61.8 years; frequent users: 61.2 years; nonfrequent users: 53.4 years; p < 0.01) and required immediate and mental health care more frequently (18.6% of high-frequency users, 17.4% of frequent users, 13.5% of nonfrequent users, and 6.6%; 3.3%, 2.3%; p < 0.01). High-frequency users also used the ED for nonurgent reasons more than remaining groups (6.1%, 3.5%, 3.1%; p < 0.01). High-frequency users are an aged and heterogeneous group, requiring tailored interventions to improve care.
Sections du résumé
BACKGROUND
BACKGROUND
Knowing the distinctive features of patients with the highest utilization of the emergency department (ED) is paramount to finding adequate alternatives to ED care for selected patients and improving health care quality and efficiency.
OBJECTIVE
OBJECTIVE
This study aimed to identify ED high-frequency users and compare their clinical and utilization characteristics with other ED users.
METHODS
METHODS
Secondary data analysis of ED visits and patients database from a Portuguese public urban hospital. Retrospective study of adults visiting the ED in 2016 (61,403 patients; 95,643 visits), comparing demographic and clinical characteristics of patients and clinical and temporal characteristics of ED visits between high-frequency users (>10 ED visits in 2016) and frequent (4-10 ED visits) and nonfrequent (1-3 ED visits) users.
RESULTS
RESULTS
We identified 169 high-frequency users (0.3% of patients and 3.0% of ED visits) with an average number of 16.9 visits in 2016. Patients in this group were older (61.8 years; frequent users: 61.2 years; nonfrequent users: 53.4 years; p < 0.01) and required immediate and mental health care more frequently (18.6% of high-frequency users, 17.4% of frequent users, 13.5% of nonfrequent users, and 6.6%; 3.3%, 2.3%; p < 0.01). High-frequency users also used the ED for nonurgent reasons more than remaining groups (6.1%, 3.5%, 3.1%; p < 0.01).
CONCLUSION
CONCLUSIONS
High-frequency users are an aged and heterogeneous group, requiring tailored interventions to improve care.
Identifiants
pubmed: 32349880
pii: S0736-4679(20)30148-7
doi: 10.1016/j.jemermed.2020.03.012
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
153-160Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.