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Persistent frequent emergency department users with chronic conditions: A population-based cohort study
Yohann Moanahere Chiu1,2, Alain Vanasse1,2, Josiane Courteau1
1Département de médecine de famille et de médecine d'urgence, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
Plos One
|February 13, 2020
Summary
Persistent frequent emergency department (ED) users, defined as those with at least four visits annually for three consecutive years, represent 1.10% of patients. Poor socioeconomic status and comorbidities are key factors, with prior ED visits being the strongest predictor.
Area of Science:
- Healthcare utilization research
- Public health
- Epidemiology
Background:
- Frequent emergency department (ED) use is defined as four or more visits per year.
- Persistent frequent users maintain this high utilization over multiple years.
- This study focuses on adults with chronic conditions to understand persistent frequent ED use.
Purpose of the Study:
- Estimate the prevalence of persistent frequent ED use.
- Identify factors associated with persistent frequent ED use versus occasional frequent ED use.
- Compare characteristics of persistent frequent users with other ED user groups.
Main Methods:
- Retrospective cohort study utilizing Quebec administrative databases.
- Included adult patients with chronic conditions visiting the ED in 2012, excluding those deceased within three years.
- Analyzed sociodemographic factors, comorbidities, and prior healthcare utilization using multivariable logistic regression.
Main Results:
- 1.10% (3,357/297,182) of patients were identified as persistent frequent users.
- Key characteristics included poor socioeconomic status, mental/physical comorbidities, and substance abuse.
- Previous ED visits were the most significant predictor of persistent frequent use.
Conclusions:
- Persistent frequent ED users share traits with occasional frequent users but are generally younger and have poorer socioeconomic status.
- Understanding the contributing factors to persistent frequent ED use requires further investigation.
- Targeted interventions may be necessary for this specific patient subgroup.
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