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J Korean Soc Emerg Med > Volume 32(3); 2021 > Article
Journal of The Korean Society of Emergency Medicine 2021;32(3): 263-272.
Identifying characteristics of frequent and highly frequent users of the emergency department: a retrospective cross-sectional observational study
Byeung Ki Ahn1 , Suckju Cho2 , Sangmi Kim3 , Tiffany Jane Lee4 , Joonbum Park5
1Health and Medical Research Institute, Gyeonggi-do, Korea
2Department of Emergency Medicine, Pusan National University Hospital, Busan, Korea
3Department of Big Data Analytics, Ewha Womans University, Seoul, Korea
4English Literature & Molecular and Cellular Biology, Vanderbilt University, Nashville, TN, USA
5Department of Emergency Medicine, Soonchunhyang University Hospital, Seoul, Korea
Correspondence  Joonbum Park ,Tel: 02-709-9117, Fax: 02-795-3687, Email: jesumania@gmail.com,
Received: November 28, 2020; Revised: March 24, 2021   Accepted: April 19, 2021.  Published online: June 30, 2021.
Since the characteristics of frequent emergency department (ED) users are heterogeneous, it is impossible to mitigate overcrowding of the ED without basic data of diagnoses and risk factors of frequent ED users. Instead of selecting for a limited disease group, our study included all ED patients, thereby providing invaluable information to help predict patient demand for medical resources.
Frequent ED users are defined as patients who visit an ED between 7-17 times per calendar year, and highly frequent ED users are patients who visit an ED 18 times or more during the same period. Our study developed two logistic regression models comparing frequent users with less frequent users, and highly frequent users with frequent users.
Although 98.98% of all patients were determined as less frequent ED users, they encompassed only 92.27% of all ED visits. Frequent ED users were most strongly identified as wound dressing follow-up visits and liver diseases (standardized βvalue of 3.29 and 2.31, respectively). However, considering the different disease categories, no differences were obtained between highly frequent ED and frequent ED users.
The diagnoses and risk factors related to frequent ED visits in Korea identified in this study, will provide important reference for future research aimed at reducing ED overcrowding. By further analyzing the risk factors associated with frequent ED use, non-emergency administrative systems or medical facilities can be utilized to reduce the ED overload.
Key words: Emergencies; Emergency service, hospital; Disease
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