Frequent Users of Emergency Departments: Developing Standard Definitions and Defining Prominent Risk Factors
Abstract
Study objective We identify factors that define frequent and highly frequent emergency department (ED) users.Methods Administrative health care records were used to define less frequent (1 to 6 visits), frequent (7 to 17 visits), and highly frequent (≥18 visits) ED users. Analyses were conducted to determine the most unique demographic, disease, and health care use features of these groups.Results Frequent users composed 9.9% of all ED visits, whereas highly frequent users composed 3.6% of visits. Compared with less frequent users, frequent users were defined most strongly by their substance abuse challenges and by their many visits to primary care and specialist physicians. Substance abuse also distinguished highly frequent from frequent ED users strongly; 67.3% versus 35.9% of these patient groups were substance abusers, respectively. Also, 70% of highly frequent versus only 17.8% of frequent users had a long history of frequent ED use. Last, highly frequent users did not use other health care services proportionally more than their frequent user counterparts, suggesting that these former patients use EDs as a main source of care.Conclusion This research develops objective thresholds of frequent and highly frequent ED use. Although substance abuse is prominent in both groups, only highly frequent users seem to visit EDs in place of other health care services. Future analyses can investigate these patterns of health care use more closely, including how timely access to primary care affects ED use. Cluster analysis also has value for defining frequent user subgroups who may benefit from different yet equally effective treatment options.
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The association between high risk of recurrent ED use and high family physician use has been noted previously in other populations.
“This has been noted previously in other populations”
From Factors associated with recurrent emergency department visits among people living with dementia: A retrospective cohort study (2023) · cites this paper as [41]
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- Authors
- Doupe, M. B., Palatnick, W., Day, S., Chateau, D., Soodeen, R.-A., Burchill, C., & Derksen, S.
- Affiliations
- University of Manitoba (CA)
- York University (CA)
- Corresponding author
- Doupe, Malcolm B.
- Venue
- Annals of Emergency Medicine
- Publisher
- Elsevier BV
- Published
- 2012-07
- Volume
- 60
- Issue
- 1
- Pages
- 24-32
- ISSN
- 0196-0644 (ISSN-L)
- OpenAlex
- W1967763450
- Cited by
- 253
- References
- 51
- Citations by year
- 2026: 10 · 2025: 10 · 2024: 4 · 2023: 13 · 2022: 24 · 2021: 25 · 2020: 24 · 2019: 24 · 2018: 23 · 2017: 19 · 2016: 27 · 2015: 17 · 2014: 18 · 2013: 10 · 2012: 4
- FWCI
- 17.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Emergency Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Keywords
- frequent emergency department users, emergency department utilization, substance abuse, primary care access, risk factors, emergency department overcrowding, patient subgroups
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Chronic Disease, Emergency Service, Hospital, Female, Health Services, Humans, Male, Manitoba, Middle Aged, Primary Health Care, Risk Factors, Socioeconomic Factors, Logistic Models, Substance-Related Disorders, Young Adult
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