Locker Thomas E, Baston Simon, Mason Suzanne M, Nicholl Jon
School of Health and Related Research, University of Sheffield, Sheffield, UK.
Emerg Med J. 2007 Jun;24(6):398-401. doi: 10.1136/emj.2006.043844.
This study aimed to develop a definition of frequent use of an emergency department (ED) by comparing differences in the observed frequency distribution with that of a theoretical frequency distribution.
A retrospective analysis of attendance of ED and minor injury unit attendances in one city over 1 year was conducted. From these data, the expected frequency distribution was determined based upon a Poisson distribution.
During the period studied, 75,141 people attended on 98,908 occasions. The theoretical frequency distribution showed that there were 2764 (3.7%) "frequent users" presenting repeatedly due to non-random events. These patients made 12,316 (12.4%) attendances. Frequent users were older than chance users (mean age 49.7 vs 44.5 years). A greater proportion arrived by ambulance (55.3% vs 27.5%), presented with psychiatric problems (5.8% vs 1.1%) or alcohol intoxication (1.3% vs 0.5%), and were admitted to hospital (37.4% vs 19.6%).
We have identified that there is a group of patients who present repeatedly due to non-random events, confirming the existence of "frequent users". Their characteristics are clearly different to other patients in the ED. We propose that "frequent users" be defined as any patient who makes more than four attendances per year.
本研究旨在通过比较观察到的频率分布与理论频率分布的差异，制定急诊科频繁就诊的定义。
对一个城市一年内急诊科和轻伤科室就诊情况进行回顾性分析。根据这些数据，基于泊松分布确定预期频率分布。
在研究期间，75141人就诊98908次。理论频率分布显示，有2764名（3.7%）“频繁使用者”因非随机事件反复就诊。这些患者就诊12316次（12.4%）。频繁使用者比偶然使用者年龄大（平均年龄49.7岁对44.5岁）。乘坐救护车前来就诊的比例更高（55.3%对27.5%），存在精神问题（5.8%对1.1%）或酒精中毒（1.3%对0.5%），且住院比例更高（37.4%对19.6%）。
我们已确定存在一组因非随机事件反复就诊的患者，证实了“频繁使用者”的存在。他们的特征与急诊科其他患者明显不同。我们建议将“频繁使用者”定义为每年就诊超过4次的任何患者。
