[How do we help children who visit an emergency department frequently?]

Area of Science:

• Pediatric Emergency Medicine
• Healthcare Management
• Clinical Epidemiology

Context:

• Frequent use of emergency departments (EDs) by pediatric patients, termed 'frequent flyers' (FFs), poses a significant challenge to healthcare systems.
• Dutch research indicates that nearly 5% of the pediatric population in university hospital EDs are FFs, contributing over 20% of all pediatric visits.
• A substantial majority (75%) of these pediatric FFs have existing comorbidities, highlighting the complexity of their healthcare needs.

Purpose:

• To identify distinct patient subgroups among pediatric frequent flyers (FFs) in an emergency department setting.
• To investigate the characteristics of FFs, particularly those with comorbidities, to understand the drivers of frequent ED utilization.
• To propose a framework for recognizing and managing different FF groups with tailored care plans to optimize resource allocation and patient outcomes.

Summary:

• Dutch research identified that approximately 5% of pediatric emergency department patients are frequent flyers (FFs), responsible for over 20% of all pediatric visits.
• The study found that three-quarters of these pediatric FFs have one or more comorbidities.
• A hypothesis is presented to categorize FFs into three groups: those with acute comorbidity exacerbations, those with medical complexity, and those with psychosocial fragility.

Impact:

• Recognizing these distinct FF subgroups can lead to the development of personalized care strategies.
• Implementing tailored care plans has the potential to significantly reduce unnecessary emergency department visits for pediatric frequent flyers.
• This approach can improve healthcare efficiency and patient outcomes by addressing the specific needs of vulnerable pediatric populations and their families.