Characteristics of frequent adult emergency department users

Lee, Ji Han; Park, Gwan Jin; Kim, Sang Chul; Kim, Hoon; Lee, Suk Woo

doi:10.1097/md.0000000000020123

Cited by 10 publications

(15 citation statements)

References 29 publications

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“…The outcome variable was the frequency of ED user visits before and during the COVID-19 pandemic. Frequent ED users were defined as those with four or more ED visits in a year, and occasional ED users were defined as those with one to three ED visits [ 2 , 10 , 21 ].…”

Section: Methodsmentioning

confidence: 99%

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Impact of the COVID-19 Pandemic on Healthcare-Seeking Behaviors among Frequent Emergency Department Users: A Cohort Study

Chou

Yen

Chu

et al. 2021

IJERPH

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In 2020, Taiwan’s healthcare system faced a notable burden imposed by the coronavirus disease (COVID-19) pandemic. Emergency department (ED) is a high-risk area for severe acute respiratory syndrome coronavirus 2 transmission. The effect of COVID-19 on the utilization of ED services among frequent ED users remains unknown. This cohort study determined the impact of the COVID-19 pandemic on healthcare-seeking behaviors among frequent ED users at Taipei City Hospital, Taiwan. We included ED users aged ≥18 years admitted to Taipei City Hospital during February 2019–January 2020 (before the pandemic) and February 2020–January 2021 (during the pandemic). Frequent ED users were patients with four or more ED visits per year. Stepwise logistic regression was performed to identify predictors of frequent ED use during the COVID-19 pandemic. Frequent ED users had shorter hospital stays in the ED during the pandemic. After adjusting for sociodemographic factors and other covariates, patients with a triage status of level 4–5, pneumonia diagnosis, giddiness, or dyspnea were more likely frequent ED visitors during the COVID-19 pandemic. To reduce the risk of acquiring COVID-19, it is important to utilize territorial healthcare or telehealth to avoid inappropriate ED visits for patients with a low level of risk or chronic disease.

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Section: Methodsmentioning

confidence: 99%

“…Emergency department (ED) crowding is a burden on public health [ 1 , 2 ], so understanding the characteristics of frequent ED users is a key concern of healthcare systems and policy makers [ 3 , 4 ]. Taiwan’s implementation of National Health Insurance in 1994 enhanced public access to healthcare.…”

Section: Introductionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Healthcare-Seeking Behaviors among Frequent Emergency Department Users: A Cohort Study

Chou

Yen

Chu

et al. 2021

IJERPH

View full text Add to dashboard Cite

show abstract

“…Those with previous ED visits and hospitalizations were at high risk of ED visit, hospitalization, and death independent of other sociodemographic, medical, and behavioral factors in our study. A previous study from a single center ED revealed that frequent ED users were more likely to be in poorer health, older, or have a chronic disease or a mental health disorder than occasional ED users [ 18 ]. Therefore, post-discharge care for ED attenders should be suggested to reduce frequent use of emergency care and to protect the capacity of the ED (i.e., paramedic-delivered care transitions intervention [ 52 , 53 ]).…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, study populations were relatively small, and generalizability to the entire Korean population was not possible. In addition, the availability of study data from medical records other than those related to the need for emergent care was limited as was individual health-related behavior data [ 8 , 13 , 16 , 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Emergency Department Visits and Consequent Hospitalization and Death in Korea Using a Population-Based National Health Database

Park

Yeo

et al. 2022

Healthcare

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We aim to investigate common diagnoses and risk factors for emergency department (ED) visits as well as those for hospitalization and death after ED visits. This study describes the clinical course of ED visits by using the 2014–2015 population data retrieved from the National Health Insurance Service. Sociodemographic, medical, and behavioral factors were analyzed through multiple logistic regression. Older people were more likely to be hospitalized or to die after an ED visit, but younger people showed a higher risk for ED visits. Females were at a higher risk for ED visits, but males were at a higher risk for ED-associated hospitalization and death. Individuals in the highest quartile of income had a lower risk of ED death relative to lowest income level individuals. Disabilities, comorbidities, and medical issues, including previous ED visits or prior hospitalizations, were risk factors for all ED-related outcomes. Unhealthy behaviors, including current smoking, heavy alcohol consumption, and not engaging in regular exercise, were also significantly associated with ED visits, hospitalization, and death. Common diagnoses and risk factors for ED visits and post-visit hospitalization and death found in this study provide a perspective from which to establish health polices for the emergency medical care system.

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“…In Portugal, patients that visited at least four times a year the ED represented, in 2015, 12% of the number of ED users, but 35.9% of the total ED episodes [5]. HU contributes to ED crowding [6,7,8,9], resulting in a reduction in quality of care, increased waiting times, and increased healthcare professionals' stress [2,10]. Regular admissions to the ED suggest that the ED is not an excellent place to treat these patients (for their clinical and social needs) [11,10,12,13].…”

Section: Introductionmentioning

confidence: 99%

Case management intervention of High Users of the Emergency Department of a Portuguese hospital: a before-after design analysis

Gonçalves

Hafe

Martins

et al. 2021

Preprint

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Background: Emergency department (ED) High users (HU), defined as having more than ten visits to the ED per year, are a small group of patients that use a significant proportion of ED resources. The High Users Resolution Group(GRHU) identifies and provides care toHUto improve their health situation and reduce their visit frequency to the ED by delivering patient-centered, case management integrated care. Objectives: The main objective of this study was to measure the impact in terms of hospital visits of the GRHU intervention. Additionally, we aim to compare the program costs against its potential savings or additional costs. Finally, we intend to study the impact of the intervention across different groups of patients. Methods: We studied The changes triggered by the GRHU program in a retrospective non-controlled before-after analysis of patients’ hospital utilization data on six and 12-month windows from the first appointment. The GRHU team provided the patients’ and cost data. Results: A total of 238 EDHUwere intervened. A sample of 88 patients was analyzed on the 12-month window as they fulfilled all inclusion criteria. This intervention was associated with a statistically significant reduction of 51% in ED use and hospitalizations, and a non-statistically significant increase in the total number of outpatient appointments. Overall costs reduced 43.56%. We estimated the intervention costs to be€162,847.82. The net cost saving was€104,305.25. The program’s Return on Investment (ROI) was estimated to be€2.3. Conclusions: Patient-centered case management for EDHUseems to effectively reduce ED visits and hospitalizations, leading to the more appropriate use of resources.

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Characteristics of frequent adult emergency department users

Abstract: Supplemental Digital Content is available in the text

Cited by 10 publications

References 29 publications

Impact of the COVID-19 Pandemic on Healthcare-Seeking Behaviors among Frequent Emergency Department Users: A Cohort Study

Impact of the COVID-19 Pandemic on Healthcare-Seeking Behaviors among Frequent Emergency Department Users: A Cohort Study

Factors Associated with Emergency Department Visits and Consequent Hospitalization and Death in Korea Using a Population-Based National Health Database

Case management intervention of High Users of the Emergency Department of a Portuguese hospital: a before-after design analysis

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