Characteristics of Pediatric Frequent Users of Emergency Departments in Alberta and Ontario

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Rhonda J. Rosychuk ◽  
Anqi Chen ◽  
Andrew McRae ◽  
Patrick McLane ◽  
Maria B. Ospina ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Frequent Users

Characteristics of frequent paediatric users of emergency departments in England: an observational study using routine national data

2020 ◽  
pp. emermed-2019-209122
Author(s):  
Geva Greenfield ◽  
Mitch Blair ◽  
Paul P Aylin ◽  
Sonia Saxena ◽  
Azeem Majeed ◽  
...  
Keyword(s):  
Ethnic Groups ◽  
Emergency Departments ◽  
National Data ◽  
Frequent User ◽  
Frequent Users ◽  
Frequent Attender ◽  
Random Intercept ◽  
Frequent Attendance ◽  
Lower Likelihood ◽  
Deprived Areas

BackgroundFrequent attendances of the same users in emergency departments (ED) can intensify workload pressures and are common among children, yet little is known about the characteristics of paediatric frequent users in EDs.AimTo describe the volume of frequent paediatric attendance in England and the demographics of frequent paediatric ED users in English hospitals.MethodWe analysed the Hospital Episode Statistics dataset for April 2014–March 2017. The study included 2 308 816 children under 16 years old who attended an ED at least once. Children who attended four times or more in 2015/2016 were classified as frequent users. The preceding and subsequent years were used to capture attendances bordering with the current year. We used a mixed effects logistic regression with a random intercept to predict the odds of being a frequent user in children from different sociodemographic groups.ResultsOne in 11 children (9.1%) who attended an ED attended four times or more in a year. Infants had a greater likelihood of being a frequent attender (OR 3.24, 95% CI 3.19 to 3.30 vs 5 to 9 years old). Children from more deprived areas had a greater likelihood of being a frequent attender (OR 1.57, 95% CI 1.54 to 1.59 vs least deprived). Boys had a slightly greater likelihood than girls (OR 1.05, 95% CI 1.04 to 1.06). Children of Asian and mixed ethnic groups were more likely to be frequent users than those from white ethnic groups, while children from black and 'other' had a lower likelihood (OR 1.03, 95% CI 1.01 to 1.05; OR 1.04, 95% CI 1.01 to 1.06; OR 0.88, 95% CI 0.86 to 0.90; OR 0.90, 95% CI 0.87 to 0.92, respectively).ConclusionOne in 11 children was a frequent attender. Interventions for reducing paediatric frequent attendance need to target infants and families living in deprived areas.

scholarly journals Characteristics of frequently attending children in hospital emergency departments: a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e051409
Author(s):  
Geva Greenfield ◽  
Olivia Okoli ◽  
Harumi Quezada-Yamamoto ◽  
Mitch Blair ◽  
Sonia Saxena ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Departments ◽  
Hospital Emergency ◽  
Long Term Conditions ◽  
Frequent Users ◽  
Frequent Attendance ◽  
Wide Range ◽  
The Usa ◽  
Common Policies ◽  
Hospital Emergency Departments

ObjectiveTo summarise the literature on frequent attendances to hospital emergency departments (EDs) and describe sociodemographic and clinical characteristics of children who attend EDs frequently.SettingHospital EDs.ParticipantsChildren <21 years, attending hospital EDs frequently.Primary outcome measuresOutcomes measures were defined separately in each study, and were predominantly the number of ED attendances per year.ResultsWe included 21 studies representing 6 513 627 children. Between 0.3% and 75% of all paediatric ED users were frequent users. Most studies defined four or more visits per year as a ‘frequent ED’ usage. Children who were frequent ED users were more likely to be less than 5 years old. In the USA, patients with public insurance were more likely to be frequent attenders. Frequent ED users more likely to be frequent users of primary care and have long-term conditions; the most common diagnoses were infections and gastroenteritis.ConclusionsThe review included a wide range of information across various health systems, however, children who were frequent ED users have some universal characteristics in common. Policies to reduce frequent attendance might usefully focus on preschool children and supporting primary care in responding to primary care oriented conditions.

Characteristics of Frequent Users of Emergency Departments

2006 ◽  
Vol 48 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Kelly A. Hunt ◽  
Ellen J. Weber ◽  
Jonathan A. Showstack ◽  
David C. Colby ◽  
Michael L. Callaham
Keyword(s):  
Emergency Departments ◽  
Frequent Users

scholarly journals Frequent use of emergency departments and chronic conditions in ageing societies: a retrospective analysis based in Italy

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Enrico di Bella ◽  
Luca Gandullia ◽  
Lucia Leporatti ◽  
Walter Locatelli ◽  
Marcello Montefiori ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Chronic Conditions ◽  
Age Groups ◽  
Warning System ◽  
Multiple Chronic Conditions ◽  
Frequent Users ◽  
Administrative Dataset ◽  
Frequent Use ◽  
Demographic Risk ◽  
Demographic Risk Factors

Abstract Background Most western countries are facing relevant demographic changes, and the percentage of older people is destined to rise in the next decades. This fact is likely to affect the sustainability of healthcare systems significantly, mainly due to the connected issue of chronicity. Methods In this paper, using an extensive and comprehensive administrative dataset, we analyse the phenomenon of frequent use of emergency departments (ED) in the oldest region in Europe (i.e. Liguria) over 4 years (2013–2016). Two alternative approaches are used to define categories of ED users based on the intensity and frequency of accesses and splitting patients into different age groups. Results Results allow identifying clinical and socio-demographic risk-factors connected to different levels of ED utilisation and highlight the influential role played by chronic conditions (particularly mental disorders, respiratory diseases) and by multiple chronic conditions. Conclusions The study aims at representing an informative tool to support policy-makers in setting proper policies addressed, on the one side, towards the potentially preventable frequent users and, on the other, towards those accessing due to complex medical conditions. The results can help in building a warning system to help general practitioners in the identification of potential frequent users and to develop preventive policies.

Mortality, admission rates and outpatient use among frequent users of emergency departments: a systematic review

2015 ◽  
Vol 33 (3) ◽  
pp. 230-236 ◽  
Author(s):  
Jessica Moe ◽  
Scott Kirkland ◽  
Maria B Ospina ◽  
Sandy Campbell ◽  
Rebecca Long ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Departments ◽  
Frequent Users ◽  
Admission Rates

scholarly journals The analysis of the geographical distribution of emergency departments’ frequent users: a tool to prioritize public health policies?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Romain Hellmann ◽  
Anne-Laure Feral-Pierssens ◽  
Alain Michault ◽  
Enrique Casalino ◽  
Agnès Ricard-Hibon ◽  
...  
Keyword(s):  
Geographical Distribution ◽  
Emergency Departments ◽  
Social Deprivation ◽  
Healthcare Providers ◽  
Principal Component ◽  
Multidimensional Analysis ◽  
Health Policies ◽  
Local Health ◽  
Frequent Users ◽  
Paris Region

Abstract Background The individual factors associated to Frequent Users (FUs) in Emergency Departments are well known. However, the characteristics of their geographical distribution and how territorial specificities are associated and intertwined with ED use are limited. Investigating healthcare use and territorial factors would help targeting local health policies. We aim at describing the geographical distribution of ED’s FUs within the Paris region. Methods We performed a retrospective analysis of all ED visits in the Paris region in 2015. Data were collected from the universal health insurance’s claims database. Frequent Users (FUs) were defined as having visited ≥3 times any ED of the region over the period. We assessed the FUs rate in each geographical unit (GU) and assessed correlations between FUs rate and socio-demographics and economic characteristics of GUs. We also performed a multidimensional analysis and a principal component analysis to identify a typology of territories to describe and target the FUs phenomenon. Results FUs accounted for 278,687 (11.7%) of the 2,382,802 patients who visited the ED, living in 232 GUs. In the region, median FUs rate in each GU was 11.0% [interquartile range: 9.5–12.5]. High FUs rate was correlated to the territorial markers of social deprivation. Three different categories of GU were identified with different profiles of healthcare providers densities. Conclusion FUs rate varies between territories and is correlated to territorial markers of social deprivation. Targeted public policies should focus on disadvantaged territories.

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