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ACEP: Frequent ED Users Need Coordinated Care

Jacqueline Fellows, for HealthLeaders Media, October 10, 2012

"Regardless of the definition, most studies found frequent users to be a very small percentage of the total number of emergency patients, although these patients did make a disproportionate share of emergency department visits," he says.

The study O'Connor authored, Characteristics of Repeat Emergency Department Users at a University Medical Center, found that frequent ED users made up 20% of all the patients, but nearly 40% of visits. Other studies had lower percentages of frequent ED visits, as O'Connor said, but those visits made up a larger share of the total.

For example, a study of all non-federal acute care hospitals in San Diego, Multiple Hospital Emergency Department Visits Among Frequent Users With a Pain-Associated Discharge Diagnosis, found that 8.5% of frequent ED users (those who presented more than four times within a year) made up 34.5% of ED visits.

Results of the studies also show that high repeat users, once admitted to the hospital, are more likely to require readmission, and that worries ACEP President, Andrew Sama, MD, because of the recently enacted rule than penalizes hospitals for 30-day readmissions.

"We need to focus on implementing plans to attempt to manage these patients better. What does that mean? Physicians, family members, social workers, and home care personnel have to work together and attempt to try to manage [patients] better and prevent them from being hospitalized," says Sama.

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