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Open Access Highly Accessed Research article

Characteristics of frequent emergency department presenters to an Australian emergency medicine network

Donna Markham1 and Andis Graudins23*

Author Affiliations

1 Monash Medical Centre Emergency Department Care Co-ordination Team and Allied Health, Southern Health, Melbourne, Australia

2 Department of Medicine, Southern Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia

3 Southern Health Emergency Medicine Program, Department of Emergency Medicine, Monash Medical Centre, Clayton, Victoria, Australia

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BMC Emergency Medicine 2011, 11:21  doi:10.1186/1471-227X-11-21

Published: 16 December 2011

Abstract

Background

To describe the characteristics of emergency department (ED) patients defined as frequent presenters (FP) presenting to an Australian emergency department network and compare these with a cohort of non-frequent presenters (NFP).

Method

A retrospective chart review utilising an electronic emergency medicine patient medical record database was performed on patients presenting to Southern Health EDs from March 2009 to March 2010. Non-frequent presenters were defined as patients presenting less than 5 times and frequent presenters as presenting 8 or more times in the study period. Characteristics of both groups were described and compared.

Results

During the 12-month study period there were 540 FP patients with 4549 admissions and 73,089 NFP patients with 100,943 admissions. FP patients were slightly older with a significant increase in frequency of patients between the ages of 70 to 79 years and they were more likely to be divorced or separated than NFP patients. Frequent presenters to the emergency department were more likely to utilise the ambulance service to arrive at the hospital, or in the custody of police than NFP patients. FPs were more likely to be admitted to hospital, more likely to have an admission to a mental health bed than NFP patients and more likely to self-discharge from the emergency department while waiting for care.

Conclusions

There are major implications for the utilisation of limited ED resources by frequent presenters. By further understanding the characteristics of FP we may be able to address the specific health care needs of this population in more efficient and cost effective ways. Further research analysing the effectiveness of targeted multidisciplinary interventions aiming to reduce the frequency of ED attendances may be warranted.