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Frequent visitors 'merit attention'

Published 08/05/2015

Research suggests frequent visitors to emergency units have legitimate reasons to do so
Research suggests frequent visitors to emergency units have legitimate reasons to do so

People who go to accident and emergency regularly are more than twice as likely to die, be admitted to hospital or require other outpatient treatment, a study has suggested.

Researchers in Canada said an increase in patients attending A&E departments has become a strain in industrialised countries around the world.

They analysed multiple studies on emergency care, concluding that "frequent users are a distinct and high-risk group" and "not simply inappropriate consumers of... resources".

The team found that a cross seven studies examining mortality, frequent users had a 2.2-fold increased odds of death compared with non-frequent users.

From 28 studies looking at assessing hospital admissions they found an increased chance of 2.58 per patient, and 10 studies on outpatient visits showed a 2.65-fold increased risk of having at least one outpatient encounter after their emergency visit.

The most common definition of frequent users across the studies was patients who visited A&E at least four times in one year.

An investigation by the BBC last year found that nearly 12,000 people made more than 10 visits to the same unit in 2012/13, with around 150 of those attending more than 50 times.

In the most extreme cases, one patient at Luton and Dunstable Hospital went to casualty 234 times over the course of the year, while another person went to Sheffield's Northern General 223 times.

But the study, which was led by the University of Alberta and is published in the British Medical Journal, said such frequent users are a "vulnerable patient group" and more should be done to identify subgroups.

They might include people with mental health and addiction issues, homelessness or unstable housing, chronic diseases, or patients who make frequent visits with conditions that require transient needs, for example abscess treatment, missed diagnoses or complications.

"Clearly, to view frequent users as merely a nuisance or drain on resources represents a narrow, biased and potentially dangerous view of this issue," the study authors said.

"Our findings suggest that frequent ED (emergency department) users merit focused attention, continued research and implementation of interventions designed to meet their unmet needs from practitioners, health administrators and policymakers."

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