Abstract
BackgroundA small proportion of patients referred to as ‘frequent attenders’ account for a large proportion of hospital activity such as ED attendances and admissions. There is a lack of recent, national estimates of the volume of frequent ED attenders. We aimed to estimate the volume and age distribution of frequent ED attenders in English hospitals.MethodWe included all attendances at all major EDs across England in the financial year 2016–2017. Patients who attended three times or more were classified as frequent attenders. We used a logistic regression model to predict the odds of being a frequent attender by age group.Results14 829 519 attendances were made by 10 062 847 patients who attended at least once. 73.5% of ED attenders attended once and accounted for 49.8% of the total ED attendances. 9.5% of ED attenders attended three times or more; they accounted for 27.1% of the ED attendances. While only 1.2% attended six times or more, their contribution was 7.6% of the total attendances. Infants and adults aged over 80 years were significantly more likely to be frequent attenders than adults aged 30–59 years (OR=2.11, 95% CI 2.09 to 2.13, OR=2.22, 95% CI 2.20 to 2.23, respectively). The likelihood of hospital admission rose steeply with the number of attendances a patient had.ConclusionOne in 10 patients attending the ED are frequent attenders and account for over a quarter of attendances. Emergency care systems should consider better ways of reorganising health services to meet the needs of patients who attend EDs frequently.
Funder
National Institute for Health Research
Subject
Critical Care and Intensive Care Medicine,General Medicine,Emergency Medicine
Reference17 articles.
1. Kings Fund . What’s going on with A&E waiting times?Available: https://www.kingsfund.org.uk/projects/urgent-emergency-care/urgent-and-emergency-care-mythbusters [Accessed 1 Oct 2018].
2. NHS England . A&E Attendances and Emergency Admissions. Available: https://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting-times-and-activity/ [Accessed 29 Nov 2017].
3. King’s Fund . How Hospital activity in the NHS in England has changed over time. Available: https://www.kingsfund.org.uk/publications/hospital-activity-funding-changes [Accessed 25 Jun 2018].
4. Characteristics of frequent users of the emergency department in the general adult population: a systematic review of international healthcare systems;Soril;Health Policy,2016
5. Frequent users of Massachusetts emergency departments: a statewide analysis;Fuda;Ann Emerg Med,2006
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