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Factors associated with persistent multiyear frequent emergency department use
Theodoros Giannouchos1, Ronald Pirrallo2,3, Benjamin Ukert4
1Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA giannout@mailbox.sc.edu.
Emergency Medicine Journal : EMJ
|May 10, 2023
Summary
Persistent frequent emergency department (ED) users are a distinct group with specific characteristics. Understanding these differences is key to developing targeted interventions for frequent ED users.
Area of Science:
- Health Services Research
- Public Health
- Healthcare Management
Background:
- Most frequent emergency department (ED) users do not consistently utilize ED services over multiple years.
- Understanding the characteristics of persistent frequent ED users is crucial for effective healthcare resource allocation.
Purpose of the Study:
- To investigate the association between persistent multiyear frequent ED use and individual characteristics.
- To differentiate persistent frequent ED users from non-persistent frequent ED users.
Main Methods:
- Retrospective analysis of 2012-2017 ED databases from Florida, Massachusetts, and New York.
- Multivariable regression models to assess characteristics of persistent frequent ED users (≥4 visits/year for multiple years) versus non-persistent frequent users.
Main Results:
- 14.9% of frequent ED users in 2012 remained frequent users for 2-3 years; 3.6% for 4-6 years.
- Persistent frequent ED users had more index year visits, lacked insurance or had public insurance, and had more chronic conditions and less medically urgent visits.
- Significant differences were observed between persistent and non-persistent frequent ED users.
Conclusions:
- Persistent frequent ED users represent a specific subgroup with identifiable characteristics.
- Interventions for frequent ED users should consider the differences between persistent and non-persistent users to improve outcomes and reduce costs.
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