Differences between frequent emergency department users in a secondary rural hospital and a tertiary suburban hospital in central Japan: a prevalence study

Author:

Kaneko MakotoORCID,Inoue Machiko,Okubo Masashi,Furgal Allison K Cullen,Crabtree Benjamin F,Fetters Michael D

Abstract

ObjectivesAlthough frequent emergency department (ED) use is a global issue, little research has been conducted in a country like Japan where universal health insurance is available. The study aims to (1) document the proportion of ED visits that are by frequent users and (2) describe the differences in characteristics of frequent ED users and other ED users including expenditures between a secondary and a tertiary hospital.DesignA prevalence study for a period of 1 year.SettingA secondary hospital and a tertiary hospital in central Japan.ParticipantsAll patients who presented to the EDs.Primary outcome measuresWe defined frequent ED user as a patient who visited the ED≥5 times/year. The main outcome measures were the proportion of frequent ED users among all ED users and the proportion of healthcare expenditures by the frequent ED users among all ED expenditures.ResultsOf 25 231 ED visits over 1 year, 134 frequent ED users accounted for 1043 visits—0.66% of all ED users, comprised 4.1% of all ED visits, and accounted for 1.9% of total healthcare expenditures. Median ED visits per one frequent ED user was 7.9. At the patient level, after adjusting for age, gender and receiving public assistance, older age (OR 1.01, 95% CI: 1.00 to 1.02) and receiving public assistance (OR 7.19, 95% CI 2.87 to 18.07) had an association with frequent ED visits. At the visit-level analysis, evaluation by internal medicine (OR 1.27, 95% CI 1.02 to 1.57), psychiatry (OR 124.69, 95% CI 85.89 to 181.01) and obstetrics/gynaecology (OR 2.77, 95% CI 2.09 to 3.67) were associated with frequent ED visits.ConclusionThe proportion of frequent ED users, of total visits, and of expenditures attributable to them—while still in the low end of the distribution of published ranges—are lower in this study from Japan than in reports from many other countries.

Funder

Grant-in-Aid for Research Activity Start-up

Publisher

BMJ

Subject

General Medicine

Reference36 articles.

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

2. Reducing Frequent Visits to the Emergency Department: A Systematic Review of Interventions

3. Frequent callers to and users of emergency medical systems: a systematic review

4. Building a citywide, all-payer, hospital claims database to improve health care delivery in a low-income, urban community;Gross;Popul Health Manag,2013

5. Warning W , Wood J , Letcher A , et al . Working with super-utilizer population: the experience and recommendations. Super utilizer population: Recommendations of five South Central Pennsylvania High Utilizer. http://www.aligning4healthpa.org/pdf/High_Utilizer_report.pdf. (accessed March 1, 2020).

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