Appropriateness of frequent use of emergency departments: A retrospective analysis in Rome, Italy

Author:

Furia Giuseppe,Vinci Antonio,Colamesta Vittoria,Papini Paolo,Grossi Adriano,Cammalleri Vittoria,Chierchini Patrizia,Maurici Massimo,Damiani Gianfranco,De Vito Corrado

Abstract

BackgroundFrequent users (FUs) are patients who repeatedly and inappropriately visit the emergency department (ED) for low-grade symptoms that could be treated outside the hospital setting. This study aimed to investigate the phenomenon of the FU in Rome by profiling such users and analyzing ED attendance by FUs.MethodsThe analysis was carried out for attendance in 2021 at 15 EDs in the Local Health Authority Roma 1 geographical area. A digital app collected data, including information on the following variables: number of attendance, demographic characteristics, emergency medical service (EMS) usage, triage code, and appropriateness of attendance. COVID-19 diagnosis was also studied to analyze any possible influence on ED attendance. Differences between FUs and non-FUs were investigated statistically by t-test and chi-square test. Univariate analysis and multivariable logistic regression were performed to analyze the associated factors.ResultsA total of 122,762 ED attendance and 89,036 users were registered. The FU category represented 2.9% of all users, comprising 11.9% of total ED attendance. There was a three times higher frequency of non-urgent codes in attendance of FU patients (FU: 9.7%; non-FU: 3.2%). FUs were slightly more likely to have used the EMS (13.6% vs. 11.4%) and had a lower frequency of appropriate ED attendance (23.8% vs. 27.0%). Multivariate logistic analysis confirmed a significant effect of triage code, gender, age, EMS usage, and COVID-19 diagnosis for the appropriateness of attendance. The results were statistically significant (p < 0.001).ConclusionThe FU profile describes mostly non-urgent and inappropriate attendance at the ED, including during the COVID-19 pandemic. This study represents an important tool for strengthening preventive policies outside the hospital setting. The Italian National Recovery and Resilience Plan represents an excellent opportunity for the development of new strategies to mitigate the phenomenon of FUs.

Funder

Sapienza Università di Roma

Publisher

Frontiers Media SA

Subject

Public Health, Environmental and Occupational Health

Reference64 articles.

1. Factors associated with frequent use of emergency-department services in a geriatric population: a systematic review;Dufour;BMC Geriatr.,2019

2. Frequent use of emergency departments and chronic conditions in ageing societies: a retrospective analysis based in Italy;Di Bella;Popul Health Metr.,2020

3. La struttura e le attività del SSN;Cinelli,2020

4. Osservatorio della Salute delle Regioni Italiane;Carle;Assistenza Ospedaliera Rapporto Osservasalute.,2022

5. Adverse events in patients with return emergency department visits;Calder;BMJ Qual Saf.,2015

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