A Comprehensive View of Frequent Emergency Department Users Based on Data from a Regional HIE

Area of Science:

• Health Informatics
• Public Health
• Healthcare Management

Background:

• A subset of patients frequently utilize emergency departments (EDs), often across multiple facilities.
• Regional health information exchanges (HIEs) offer a comprehensive view of ED utilization patterns.

Purpose of the Study:

• To characterize frequent ED users (FEDUs) within a region using a comprehensive HIE.
• To identify demographic and clinical factors associated with being a FEDU.

Main Methods:

• A regional HIE database of adult ED encounters over one year was analyzed.
• Patients with four or more ED visits were classified as FEDUs.
• Logistic regression identified predictors of FEDU status.

Main Results:

• 9.6% of 127,672 patients were identified as FEDUs.
• Key predictors included age (35-44), African American race, Medicaid/Medicare/dual payer status, and specific ICD-9 codes (e.g., mental disorders, respiratory diseases).
• No significant gender-based differences in FEDU status were observed.

Conclusions:

• HIE data effectively identifies regional FEDUs across different healthcare systems.
• Findings can inform targeted care coordination and medical home initiatives.
• Further research into the causes of frequent ED use and intervention development is warranted.