Retrospective Analyses of the Frequent Emergency Department Users

Background: Emergency department (ED) demand and overcrowding was increasing all over the world and significant portion of this overcrowding was created by “frequent users”. The aim of the study is to define the characteristics of this group of patient who contribute toward a disproportionate number of ED visits.
Methods: All ED visits during one-year period between 01.01.2018 and 31.12.2018 were investigated retrospectively by using electronic registration system of the hospital. Patients attended to ED ≥4 times between this periods were accepted as “frequent user”. Social-history related factors, disease related factors and care related factors of frequent users were investigated.
Results: A total of 335457 ED visits made in a calendar year of 2018 were investigated. Frequents users were 6.8% of all ED patient population and made 22.9% of all ED visits. Female gender proportion was greater among frequent ED users and frequent users were younger than occasional users. Yellow / red triage code ratio was higher in frequent user group and also median length of hospital stay was significantly longer. Uninsured patient was two times higher at the frequent users and half of this patient was immigrant or refugees.
Conclusion: Frequent users place a significant burden on the increasing patient volume of ED’s. Welfare status was an important indicator for being frequent user. However frequent users are a very heterogeneous patient group and more research is needed in order to better understand factors leading to frequent ED use and to develop effective strategies to meet their complex health care needs.