Rate, characteristics, and factors associated with high emergency department utilization

Van Der Linden, MC; Van Den Brand, CL; Van Der Linden, N; Rambach, AH; Brumsen, C

Rate, characteristics, and factors associated with high emergency department utilization

Van Der Linden, MC Van Den Brand, CL Van Der Linden, N Rambach, AH Brumsen, C

Permalink

Publication Type:: Journal Article
Citation:: International Journal of Emergency Medicine, 2014, 7 (1)
Issue Date:: 2014-01-01

Open Access

Copyright Clearance Process

Recently Added
In Progress
Open Access

This item is open access.

Adobe PDF

Download Published VersionAdobe PDF (288.43 kB)

View on publisher's site

View statistics

Full metadata record

Field	Value	Language
dc.contributor.author	Van Der Linden, MC	en_US
dc.contributor.author	Van Den Brand, CL	en_US
dc.contributor.author	Van Der Linden, N	en_US
dc.contributor.author	Rambach, AH	en_US
dc.contributor.author	Brumsen, C	en_US
dc.date.issued	2014-01-01	en_US
dc.identifier.citation	International Journal of Emergency Medicine, 2014, 7 (1)	en_US
dc.identifier.issn	1865-1372	en_US
dc.identifier.uri	http://hdl.handle.net/10453/116018
dc.description.abstract	Background: Patients with high emergency department (ED) utilization account for a disproportionate number of ED visits. The existing research on high ED utilization has raised doubts about the homogeneity of the frequent ED user. Attention to differences among the subgroups of frequent visitors (FV) and highly frequent visitors (HFV) is necessary in order to plan more effective interventions. In the Netherlands, the incidence of high ED utilization is unknown. The purpose of this study was to investigate if the well-documented international high ED utilization also exists in the Netherlands and if so, to characterize these patients. Therefore, we assessed the proportion of FV and HFV; compared age, sex, and visit outcomes between patients with high ED utilization and patients with single ED visits; and explored the factors associated with high ED utilization. Methods: A 1-year retrospective descriptive correlational study was performed in two Dutch EDs, using thresholds of 7 to 17 visits for frequent ED use, and greater than or equal to 18 visits for highly frequent ED use. Results: FV and HFV (together accounting for 0.5% of total ED patients) attended the ED 2,338 times (3.3% of the total number of ED visits). FV and HFV were equally likely to be male or female, were less likely to be self-referred, and they suffered from urgent complaints more often compared to patients with single visits. FV were significantly older than patients with single visits and more often admitted than patients with single visits. Several chief complaints were indicative for frequent and highly frequent ED use, such as shortness of breath and a psychiatric disorder. Conclusions: Based on this study, high ED utilization in the Netherlands seems to be less a problem than outlined in international literature. No major differences were found between FV and HFV, they presented with the same, often serious, problems. Our study supports the notion that most patients with high ED utilization visit the ED for significant medical problems. © 2014 van der Linden et al.; licensee Springer.	en_US
dc.relation.ispartof	International Journal of Emergency Medicine	en_US
dc.relation.isbasedon	10.1186/1865-1380-7-9	en_US
dc.title	Rate, characteristics, and factors associated with high emergency department utilization	en_US
dc.type	Journal Article
utslib.citation.volume	1	en_US
utslib.citation.volume	7	en_US
utslib.for	1402 Applied Economics	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1199 Other Medical and Health Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
utslib.copyright.status	open_access
pubs.issue	1	en_US
pubs.publication-status	Published	en_US
pubs.volume	7	en_US

Abstract:

Background: Patients with high emergency department (ED) utilization account for a disproportionate number of ED visits. The existing research on high ED utilization has raised doubts about the homogeneity of the frequent ED user. Attention to differences among the subgroups of frequent visitors (FV) and highly frequent visitors (HFV) is necessary in order to plan more effective interventions. In the Netherlands, the incidence of high ED utilization is unknown. The purpose of this study was to investigate if the well-documented international high ED utilization also exists in the Netherlands and if so, to characterize these patients. Therefore, we assessed the proportion of FV and HFV; compared age, sex, and visit outcomes between patients with high ED utilization and patients with single ED visits; and explored the factors associated with high ED utilization. Methods: A 1-year retrospective descriptive correlational study was performed in two Dutch EDs, using thresholds of 7 to 17 visits for frequent ED use, and greater than or equal to 18 visits for highly frequent ED use. Results: FV and HFV (together accounting for 0.5% of total ED patients) attended the ED 2,338 times (3.3% of the total number of ED visits). FV and HFV were equally likely to be male or female, were less likely to be self-referred, and they suffered from urgent complaints more often compared to patients with single visits. FV were significantly older than patients with single visits and more often admitted than patients with single visits. Several chief complaints were indicative for frequent and highly frequent ED use, such as shortness of breath and a psychiatric disorder. Conclusions: Based on this study, high ED utilization in the Netherlands seems to be less a problem than outlined in international literature. No major differences were found between FV and HFV, they presented with the same, often serious, problems. Our study supports the notion that most patients with high ED utilization visit the ED for significant medical problems. © 2014 van der Linden et al.; licensee Springer.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/116018