scholarly journals Characteristics of frequent presenters: An analysis of 1 year of data from an Irish Emergency Department

2015 ◽  
Author(s):  
Philip A Walker ◽  
Niamh Cummins ◽  
Niamh Collins
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Living Arrangements ◽  
Age Groups ◽  
Living Alone ◽  
Medical Needs ◽  
Younger Age ◽  
Chi Squared ◽  
Free Health Care ◽  
Age Category

Introduction: Frequent presenters (FPs) to the Emergency Department (ED) have been studied heavily in international literature. Many studies suggest that maintaining services for this cohort of patients is wasteful and detracts from the needs of nonfrequent presenters. In this study we aim to describe the characteristics of FPs to the ED. We review data pertaining to frequent ED use, demographics of FPs, their preferred methods of arrival to the ED and their social living arrangements. FP's tend to rely heavily on other services as well as the ED and primary care. Methods: A systematic retrospective review of FPs attendance was performed. Results: FPs accounted for 3.9% (n=1231) of total ED attendance. The age of the FP population ranged from 19- 94 (Median = 45.5, SD 18.422). Increased ED attendance was positively associated with younger age groups. The age category accounting for the highest ED attendance was those aged between 19-35 years. From the 152 (100%) FPs, 50.7% (n=77) were males and 49.3% (n=75) were female. When the living arrangements of FPs were examined, 40.1% (n=61) lived with family, 37.5% (n=57) lived alone, 12.5% (n=19) resided in residential care while data on 9.9% (n=15) FPs was unknown. A Chi-squared analysis was computed to determine if age showed any significant correlation with living arrangements. The findings were not significant as X2 =2.148 (df3, p=0.542). Conclusions: FP's are positively associated with being young and often present with true medical needs. Many believe that frequent presentation is positively associated with free health care and living alone this is not the case. FP's are more likely to live with family and up to 17% of FP attendances have been as a result of primary care referral. FPs also present frequently to the ambulance service with almost 50% utilising the service for transport to the ED.

scholarly journals Characteristics of frequent presenters: An analysis of 1 year of data from an Irish Emergency Department

2015 ◽  
Author(s):  
Philip A Walker ◽  
Niamh Cummings ◽  
Niamh Collins
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Living Arrangements ◽  
Age Groups ◽  
Living Alone ◽  
Medical Needs ◽  
Younger Age ◽  
Chi Squared ◽  
Free Health Care ◽  
Age Category

Introduction: Frequent presenters (FPs) to the Emergency Department (ED) have been studied heavily in international literature. Many studies suggest that maintaining services for this cohort of patients is wasteful and detracts from the needs of nonfrequent presenters. In this study we aim to describe the characteristics of FPs to the ED. We review data pertaining to frequent ED use, demographics of FPs, their preferred methods of arrival to the ED and their social living arrangements. FP's tend to rely heavily on other services as well as the ED and primary care. Methods: A systematic retrospective review of FPs attendance was performed. Results: FPs accounted for 3.9% (n=1231) of total ED attendance. The age of the FP population ranged from 19- 94 (Median = 45.5, SD 18.422). Increased ED attendance was positively associated with younger age groups. The age category accounting for the highest ED attendance was those aged between 19-35 years. From the 152 (100%) FPs, 50.7% (n=77) were males and 49.3% (n=75) were female. When the living arrangements of FPs were examined, 40.1% (n=61) lived with family, 37.5% (n=57) lived alone, 12.5% (n=19) resided in residential care while data on 9.9% (n=15) FPs was unknown. A Chi-squared analysis was computed to determine if age showed any significant correlation with living arrangements. The findings were not significant as X2 =2.148 (df3, p=0.542). Conclusions: FP's are positively associated with being young and often present with true medical needs. Many believe that frequent presentation is positively associated with free health care and living alone this is not the case. FP's are more likely to live with family and up to 17% of FP attendances have been as a result of primary care referral. FPs also present frequently to the ambulance service with almost 50% utilising the service for transport to the ED.

scholarly journals Characteristics of frequent presenters: An analysis of 1 year of data from an Irish Emergency Department

2015 ◽  
Author(s):  
Philip A Walker ◽  
Niamh Cummins ◽  
Niamh Collins
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Living Arrangements ◽  
Age Groups ◽  
Living Alone ◽  
Medical Needs ◽  
Younger Age ◽  
Chi Squared ◽  
Free Health Care ◽  
Age Category

Introduction: Frequent presenters (FPs) to the Emergency Department (ED) have been studied heavily in international literature. Many studies suggest that maintaining services for this cohort of patients is wasteful and detracts from the needs of nonfrequent presenters. In this study we aim to describe the characteristics of FPs to the ED. We review data pertaining to frequent ED use, demographics of FPs, their preferred methods of arrival to the ED and their social living arrangements. FP's tend to rely heavily on other services as well as the ED and primary care. Methods: A systematic retrospective review of FPs attendance was performed. Results: FPs accounted for 3.9% (n=1231) of total ED attendance. The age of the FP population ranged from 19- 94 (Median = 45.5, SD 18.422). Increased ED attendance was positively associated with younger age groups. The age category accounting for the highest ED attendance was those aged between 19-35 years. From the 152 (100%) FPs, 50.7% (n=77) were males and 49.3% (n=75) were female. When the living arrangements of FPs were examined, 40.1% (n=61) lived with family, 37.5% (n=57) lived alone, 12.5% (n=19) resided in residential care while data on 9.9% (n=15) FPs was unknown. A Chi-squared analysis was computed to determine if age showed any significant correlation with living arrangements. The findings were not significant as X2 =2.148 (df3, p=0.542). Conclusions: FP's are positively associated with being young and often present with true medical needs. Many believe that frequent presentation is positively associated with free health care and living alone this is not the case. FP's are more likely to live with family and up to 17% of FP attendances have been as a result of primary care referral. FPs also present frequently to the ambulance service with almost 50% utilising the service for transport to the ED.

The impact of a time target on older patients attending the emergency department

2010 ◽  
Vol 27 (Suppl 1) ◽  
pp. A2.1-A2
Author(s):  
Sue Mason
Keyword(s):  
Emergency Department ◽  
Older Patients ◽  
Age Groups ◽  
Unintended Consequences ◽  
Older Patient ◽  
Younger Patients ◽  
Patient Level ◽  
Level Data ◽  
Younger Age ◽  
The Impact

IntroductionThe 4 h emergency standard for English acute trusts was introduced in 2003 and became full established by 2008 at 98% for all Emergency Department (ED) patients to be seen and discharged. This study examined the impact of the target for older patients attending departments.MethodsRoutine patient level data was received from 15 English EDs representing 774 095 individual patient attendances during May and June for 2003 to 2006. The data were used to determine the distribution of the total time spent in the EDs. Attendances were compared for older patients (65 years and above) with younger age groups.ResultsA total of 145 596 attendances were for patients aged 65+ years (18.9%). Across each year analysed, these older patients have a significantly longer median total time in the ED than those younger than 65 years (162 min vs 103 min, p<0.001). In addition, older patients are significantly more likely to leave the emergency department in the last 20 min prior to 4 h (12.4% vs 5.2% in those <65 years, p<0.001). This proportion is growing year on year in both the admitted and discharged categories of patients. Finally, older patients are significantly more likely to breach the 4-h than their younger counterparts (16.6% vs 6.3%, p<0.001).ConclusionsThere are some unintended consequences of introducing the 4 h target in UK emergency departments. While the target has reduced overall time in departments, the older patient appears to be disadvantaged relative to younger patients. Older patients are more likely to be ‘rushed through’ to other unmonitored areas of the hospital just prior to the target or to breach the target altogether. This finding calls in to question the benefits that the target is conveying for individual patients, and especially the most vulnerable in society.

scholarly journals Emergency Department Admissions Among Older Adults Living Alone With Multimorbidity

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 583-584
Author(s):  
Jon Barrenetxea ◽  
Cynthia Chen ◽  
Woon-Puay Koh ◽  
Feng Qiushi ◽  
Kelvin Bryan Tan ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Living Arrangements ◽  
Population Based ◽  
Living Alone ◽  
Health Study ◽  
Risk Of Mortality ◽  
Hospitalization Costs ◽  
Singapore Chinese ◽  
One Year

Abstract Older adults living alone are at higher risk of mortality, morbidity and healthcare utilization. As more older adults live alone, Emergency Department (ED) admissions could rapidly increase, particularly among those with multimorbidity. We studied the association of living alone on ED admissions among older adults with multimorbidity. We used data from 16,785 older adults of the population-based Singapore Chinese Health Study (mean age: 73 years, range: 61-96 years) who were interviewed in 2014-2016 for living arrangements and medical history. Participants were followed-up for one year on ED admission outcomes (number of admissions, inpatient days and hospitalization costs). We used multivariable logistic regression to study the association between living alone and ED admission, and ran two-part models (probit & generalised linear model) to estimate the association of living alone on inpatient days and hospitalization cost. We found that compared to living with others, living alone was associated with a higher odds of ED admissions [Odds Ratio (OR) 1.28, 95% Confidence Interval (CI) 1.08-1.51)], longer inpatient days (+0.61, 95% CI 0.25-0.97) and higher hospitalization costs (+322 USD, 95% CI 54-591). Compared to those living with others without multimorbidity, living alone with multimorbidity was associated with higher odds of ED admission (OR 1.64 95% CI 1.33-2.03), longer inpatient days (+0.73, 95% CI 0.29-1.17) and higher hospitalization costs (+567 USD, 95% CI 230-906). In conclusion, living alone is associated with higher odds of ED admission, longer inpatient days and higher hospitalization costs among older adults, particularly among those with multimorbidity.

scholarly journals Association of Patients’ Perception of Primary Care Provider Listening With Emergency Department Use

PRiMER ◽  
2020 ◽  
Vol 4 ◽  
Author(s):  
Katie Hinderaker ◽  
Amanda Weinmann
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Primary Care Providers ◽  
California Health Interview Survey ◽  
Care Providers ◽  
Emergency Department Use ◽  
Younger Age ◽  
Interview Survey ◽  
Ed Visits ◽  
African American Race

Introduction: This study examined whether patients’ perceptions of their primary care providers’ (PCP) listening frequency were associated with emergency department (ED) utilization, including a comparison to patients without PCPs. Methods: Data were obtained from the 2015 California Health Interview Survey. Respondents were asked if they had a PCP and how often their PCPs listened, resulting in five groups: patients without a PCP (n=4,407), and patients with a PCP who perceived the PCP’s listening frequency to be never (n=254), sometimes (n=1,282), usually (n=3,440), or always (n=11,651). Multiple linear regression was performed to determine if patient-perceived listening frequency of the PCP was associated with the patient’s number of ED visits in the prior year, adjusting for various demographic, social, and health factors. Results: Compared to patients without a PCP, patients with a PCP had on average 0.15 more ED visits in a year, highest among those whose PCPs were perceived as listening the least: never=0.55 more visits per year (95% CI: 0.09-1.02, P=.02), sometimes=0.26 (0.01-0.51, P=.04), usually=0.03 (-0.17-0.24, P=.73), and always=0.16 (-0.05-0.36, P=.13). Other significant increases in ED visits were associated with public insurance, African-American race, English proficiency, younger age, self-rated fair-to-poor health, asthma, and hypertension. Conclusions: Patients who perceived their PCP as listening less frequently had more ED visits than patients whose PCPs were perceived as listening more frequently, and compared to patients without a PCP.

scholarly journals MP12: Preparing emergency patients and providers study: patient expectations and factors leading to presentation

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S46
Author(s):  
B. Rose-Davis ◽  
C. Cassidy ◽  
S. MacPhee ◽  
D. Chiasson ◽  
J. Nunn ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Patient Expectations ◽  
Study Patient ◽  
Convenience Sample ◽  
Factors Affecting ◽  
X Ray ◽  
Emergency Patients ◽  
Chi Squared ◽  
Ed Visits

Introduction: Effective communication to develop a shared understanding of patient expectations is critical to a positive encounter in the Emergency Department (ED). However, there is limited research examining Patient/Caregiver (P/C ) expectations in the ED and what factors lead to P/C presentation. This study aims to address this gap by answering the following questions: 1) What are common P/C reported factors affecting ED presentation? 2) What are common P/C expectations of an ED visit? 3) How do P/C expectations vary based on ED site or factors affecting presentation in the ED? Methods: The Preparing Emergency Patients and Providers (PrEPP) tool was designed to collect P/C expectations, worries, perceived causes of symptoms, and factors affecting presentation from a convenience sample of patient visits to the emergency department (ED). The PrEPP tool was provided to all P/Cs with CTAS 2-5 when they registered at one of 4 EDs in the Halifax area from January to June 2016. Completed tools were collected in a REDCap database where qualitative data was coded into categories (i.e. presenting illness, injury). Descriptive and chi-squared statistical analyses were performed. Results: In total, 11,418 PrEPP tools were collected; representing 12% of the total ED visits to the 4 ED sites during the study period. The main factors affecting ED presentation were: self-referral 68%, family/friends 20%, telehealth 8%, unable to see their GP 7%, GP referral 6%, or walk-in-clinic 5%. P/Cs main causes of worry were: presenting illness 19%, injury 15%, or pain 14%. The main expectations for the ED visit were to get a: physician's opinion 73%, x-ray 40%, or blood test 20%. Most P/Cs indicated they did not expect medication during (63%), or after (66%), their ED visit. There were significant differences in P/C expectations between adult and pediatric EDs (χ2 = 720.949, df = 14, P = 0.000) and those P/Cs unable or able to access primary care prior to ED presentation (χ2 = 38.980, df = 1, P = 0.000). The rate of expecting a physician's opinion at the pediatric ED was higher than the adult ED (77.6% vs 70.9%), while lower for expecting CT/MRIs (4.6% vs 11.4%). P/Cs who were unable to access primary care prior to ED presentation expected services which were available at primary care at a higher rate than those who accessed primary care (58.5% vs 36.7%). Conclusion: Our findings identify some of the factors that influence P/C's decision to present to the ED and their expectations of the ED visit.

scholarly journals Who Consult an Adult Psychiatric Emergency Department? Pertinence of Admissions and Opportunities for Telepsychiatry

Medicina ◽  
2020 ◽  
Vol 56 (6) ◽  
pp. 295 ◽  
Author(s):  
Alessandra Costanza ◽  
Viridiana Mazzola ◽  
Michalina Radomska ◽  
Andrea Amerio ◽  
Andrea Aguglia ◽  
...  
Keyword(s):  
Emergency Department ◽  
Age Groups ◽  
Primary Diagnosis ◽  
University Hospital ◽  
Psychotic Episode ◽  
Medical Evaluation ◽  
Younger Age ◽  
Diagnostic Characteristics ◽  
The University ◽  
Hypomanic Episode

Background and Objectives: Psychiatric disorders constitute frequent causes of emergency department (ED) admissions and these rates are increasing. However, referring to ED a whole range of conditions that could or should be dealt with elsewhere is imposing itself as a problematic situation. We aimed: (1) to provide a descriptive picture of the socio-demographic and diagnostic characteristics of the visits among adults at the psychiatric ED; (2) to estimate the clinical pertinence of these visits. Materials and Methods: Retrospective analysis of diagnostic/socio-demographic characteristics and clinical trajectories of patients admitted for a psychiatric condition at the adult psychiatric ED of the University Hospital of Geneva (HUG), Switzerland, during a 6-week timespan. Results: In our sample (n = 763 total admissions for psychiatric conditions; n = 702 for inclusion of patients having received a medical evaluation), depression/anxiety, suicidal behavior (SB), psychotic episode, and substance use disorder (SUD), in descending order, were the most common diagnoses for referral. Patients belonged to younger age groups (≤65 years), had a familial status other than married/in couple, and did not present an unfavorable socio-demographic profile. Concerning the pertinence for a psychiatric ED, primary diagnosis of depression/anxiety is the only variable significantly associated with different grade of degree. By the examination of the patients’ trajectory from admission to discharge, the clinical pertinence for a psychiatric ED admission existed for cases assigned to the Echelle Suisse du Tri (EST®) scale degree 1 (corresponding to most urgent and severe conditions), particularly for diagnoses of depression/anxiety associated with SB, SB as primary or comorbid diagnosis, and psychotic and manic/hypomanic episode. However, diagnoses of depression/anxiety without urgent and severe features (degrees 2, 3, 4) constituted the most frequent mode of presentation. Conclusions: Ambulatory and community-integrated settings could be more appropriate for the majority of patients admitted to adult psychiatric EDs. Moreover, the implementation of telepsychiatry strategies represents a very promising opportunity to offer these patients care continuity, reduce costs and filter the demand for psychiatric ED.

scholarly journals How Relative Age Effects Associate with Football Players’ Market Values: Indicators of Losing Talent and Wasting Money

Sports ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 99
Author(s):  
Michael Romann ◽  
Marie Javet ◽  
Stephen Cobley ◽  
Dennis-Peter Born
Keyword(s):  
Age Groups ◽  
Market Value ◽  
Age Effects ◽  
Football Players ◽  
Equal Distribution ◽  
Relative Age ◽  
Market Values ◽  
Talent Selection ◽  
Younger Age ◽  
Age Category

Background: In football, annual age-group categorization leads to relative age effects (RAEs) in talent development. Given such trends, relative age may also associate with market values. This study analyzed the relationship between RAEs and market values of youth players. Methods: Age category, birthdate, and market values of 11,738 youth male football players were obtained from the “transfermarkt.de” database, which delivers a good proxy for real market values. RAEs were calculated using odds ratios (OR) with 95% confidence intervals (95%CI). Results: Significant RAEs were found across all age-groups (p < 0.05). The largest RAEs occurred in U18 players (Q1 [relatively older] v Q4 [relatively younger] OR = 3.1) ORs decreased with age category, i.e., U19 (2.7), U20 (2.6), U21 (2.4), U22 (2.2), and U23 (1.8). At U19s, Q1 players were associated with significantly higher market values than Q4 players. However, by U21, U22, and U23 RAEs were inversed, with correspondingly higher market values for Q4 players apparent. While large typical RAEs for all playing positions was observed in younger age categories (U18–U20), inversed RAEs were only evident for defenders (small-medium) and for strikers (medium-large) in U21–U23 (not goalkeepers and midfielders). Conclusions: Assuming an equal distribution of football talent exists across annual cohorts, results indicate the selection and market value of young professional players is dynamic. Findings suggest a potential biased selection, and undervaluing of Q4 players in younger age groups, as their representation and market value increased over time. By contrast, the changing representations and market values of Q1 players suggest initial overvaluing in performance and monetary terms. Therefore, this inefficient talent selection and the accompanying waste of money should be improved.

scholarly journals Sociodemographic factors associated with Covid-19 in Canada

2021 ◽  
Vol 2 (2) ◽  
pp. 54-57
Author(s):  
Swapna Susan Mathew ◽  
Shadi Zain
Keyword(s):  
Age Groups ◽  
Sociodemographic Factors ◽  
Data Repository ◽  
Age Group ◽  
Female Patients ◽  
Younger Age ◽  
More Care ◽  
Male Patients ◽  
Death Cases ◽  
Age Category

BACKGROUND: Coronavirus disease or Covid-19 has caused more than 30 million documented infections and 1 million deaths worldwide as of Oct 2020. It was shown that several sociodemographic factors play a significant role in shaping the Covid-19 outcome and associated death rates across the globe. Thus the present study aims to study the sociodemographic parameters associated with the Covid-19 cases in Canada. MATERIAL AND METHODS: In this retrospective study, the data was collected from the Official data repository present in Canada. The patients' data were evaluated and sociodemographic parameters were checked and recorded. After the data was recorded they are categorized based on the different states and statistical analysis was done. RESULT:The present study reported that in Canada total cases as reported in the repository are 1,253,519 cases. This result indicates that maximum of the patients suffering from Covid-19 belonged to the younger age category. Compared to the males, females were more to suffer from Covid-19. Most of the patients who required hospitalization were in the 80+ year age group (28.5%). Only 1.7% of patients in the age group below 19 years are required to be hospitalized. The regional data variation showed that in Alberta female patients were more in all the age groups compared with the male patients. Saskatchewan also reported a higher number of death cases in older people. In Manitoba, in the younger age category (0-29 years) less number of female patients suffered Covid-19. Interestingly, this number reversed as the age group increased. In Ontario, 72.1% of people reported being admitted to ICU and required a ventilator. In British Columbia, the gender distribution showed no such difference among all the Covid-19 positive cases. In Quebec among the covid-19 positive cases, 47.2% were male and 52.8% were females. CONCLUSION: Age is a significant predictor of Covid-19 mortality and patients from both genders aged more than 75 years and more need to provide more care and increased medical supervision to decrease the Covid-19 casualty.

scholarly journals Epidemiology of Community-Acquired Pneumonia in Edmonton, Alberta: An Emergency Department-Based Study

2005 ◽  
Vol 12 (3) ◽  
pp. 139-142 ◽  
Author(s):  
Thomas J Marrie ◽  
Jane Q Huang
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Age Groups ◽  
Admission Rate ◽  
Community Acquired Pneumonia ◽  
Seasonal Effect ◽  
Admission Rates ◽  
Younger Age ◽  
Number Of Patients

Patients aged 17 years and older who presented to seven emergency departments in Edmonton, Alberta over a two-year period with community-acquired pneumonia (n=8144) were studied. The admission rates were 271/100,00 and 296/100,000 persons for year 1 and year 2 of the study, respectively. The admission rate increased with increasing age, peaking at 4639/100,000/year for those 90 years of age and older. In contrast, the percentage of patients who were admitted to an intensive care unit was highest for those in the younger age groups between 17 and 59 years of age. From 59 years of age and older, there was a progressive decline in the percentage of patients admitted to an intensive care unit, with approximately 1% of those in the 90 years and older age group admitted. A pronounced seasonal effect on the number of patients presenting to emergency department was also noted. During the winter months, there was up to a 50% increase in the number of cases compared with the summer months.

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