Analysis of regular attenders to the accident and emergency department

Objectives

The purpose of this study was to identify the patients who frequently use the emergency department (ED), to estimate the percentage of the overall department's workload and to determine why they choose the ED over other sources of medical care.

Methods

A retrospective study of regular attenders to the A&E Department at Xanthi General Hospital was obtained from 1 July 2003 to 30 November 2003. Frequent ED patients were identified as having more than four ED visits in this period. Age, sex, investigation performed, presenting complaints and disposal were analysed.

Results

The A&E Department at our hospital sees approximately 70,000 patients/year. The period the study was obtained, 29,732 new patients visited the department. Seventy-one patients presented 386 times, accounting for 1.3% of the department's workload. Sixty-five per cent of visits were for existing or recurrent medical problems. This group of patients had a 14.5% admission rate to the hospital compared with 9.3% for the general ED population during the study period.

Conclusion

This group of patients usually can have access to other medical sources of primary care, but they use ED for complaints they believe need immediate attention. A significant number of this group were admitted to the hospital. The department's workload and the cost, for investigations performed and inhospital admissions, are discussed.