Repeat Patients to the Emergency Department in a Statewide Database

Abstract

Objectives: To describe the epidemiology of repeat users of the emergency department (ED) using a statewide database. Methods: Probabilistic linkage was used to convert three years of statewide ED visit data into a longitudinal, patientbased data set. Patients were classified as single, repeat (at least two visits within three years), or serial (four or more visits within a 365-day period) users of the ED. Serial patients were further stratified by the number of EDs attended. Descriptive statistics were used to assess differences between patient types. Results: There were 1,370,607 separate visits associated with 780,074 patients from 1996 to 1998. While repeat and serial patients represented 33% of the patients, they accounted for 62% of the ED visits during the study period. Repeat and serial patients were younger and had smaller median ED charges per visit than singleuse patients. Serial patients attending five or more EDs were more likely to be coded as self-pay than other serial patients. Diagnosis codes relating to sprains, back problems, and headaches were prevalent among serial patients who visited five or more EDs. Approximately 30% of serial patients during the first year remained serial patients in the second year. Conclusions: Due to the high turnover in serial patients, control groups in future studies are necessary to evaluate interventions aimed at decreasing serial ED use. The likelihood of serial ED users to use multiple EDs indicates that those studying serial ED use should collect data from multiple EDs.

Predictors of frequent attenders of emergency department at an acute general hospital in Singapore

“…An index attendance was the first ED attendance of a patient defined as one that did not have a prior attendance in the preceding 12 months. The definition of a ‘frequent attender’ was adapted from other studies13 as a patient who attended the ED ≥5 times for any diagnosis. The study included index patients from 1 January to 31 December 2006 (henceforth referred to as the study cohort) who were tracked for re-attendances for 12 months up to 31 December 2007.…”

Examining the need profiles of patients with multiple emergency department visits for mental health reasons: a cross-sectional study

“…Many studies have shown that a relatively small group of patients account for a disproportionate number of ED visits [5][6][7][8][9]. Moreover, several studies have noted that mental health concerns are prevalent among these service users [10][11][12][13][14][15].…”

Risk factors for rehospitalization and inpatient care among pediatric psychiatric intake response center patients

“…Combined with rising ED visit rates, returning patients to the ED represent a growing problem. A statewide study found that repeat patients compose about two-thirds of ED patients [25]. A study of Belgian psychiatric adult patients examined time to revisit the ED [26] and reported that the majority of patients returned within a few weeks, and younger patients (0 to 44 years) were more likely to return sooner than older patients (45 years and older).…”