Auburn Clinical School, The School of Medicine, The University of Notre Dame Australia, Sydney, New South Wales, Australia.
Emergency Department, Auburn Hospital, Sydney, New South Wales, Australia.
Emerg Med Australas. 2022 Dec;34(6):898-906. doi: 10.1111/1742-6723.14011. Epub 2022 May 18.
Frequent presenters (FPs) to the ED are common and contribute to ED overcrowding. Our aim was to identify the proportion of FPs over a 12-month period and to investigate the sociodemographic, clinical and attendance characteristics of FPs.
A retrospective cohort study of adult patients (≥18 years) presenting to Auburn Hospital ED between 1 January 2018 to 31 December 2018. Patients with ≥4 presentations in 12 months were classified as FP. Multivariable logistic regression was used to assess associations between sociodemographic characteristics and FP.
During the study period, there were 22 679 presentations to the ED from 16 624 adult patients. FPs represented 5.1% (95% confidence interval [CI] 4.8-5.5) of the total population, but 15.8% of the total ED visits. Median age of FPs was 46 years (interquartile range 29-72), 51.9% were males. Age over 65 was the strongest determinant of FP (odds ratio [OR] 2.33; 95% CI 2.01-2.72 adjusted for sex). FP was more likely for Arabic speakers compared to English speakers (OR 1.54; 95% CI 1.28-1.86 adjusted for age and sex) and least likely for Mandarin speakers (adjusted OR 0.40; 95% CI 0.27-0.59).
FPs represent a significant proportion of ED visits, yet a small proportion of ED patients. Our findings suggest that identifying ways to provide targeted services to older FPs may reduce the overall rates. The differences between language groups and FP highlights the importance of social context and culture when developing targeted interventions.
急诊科（ED）的高频就诊者（FPs）较为常见，且是 ED 过度拥挤的原因之一。本研究旨在确定 12 个月期间 FPs 的比例，并调查 FPs 的社会人口学、临床和就诊特征。
这是一项对 2018 年 1 月 1 日至 2018 年 12 月 31 日期间在奥本医院 ED 就诊的成年患者（≥18 岁）进行的回顾性队列研究。在 12 个月内就诊≥4 次的患者被归类为 FP。多变量逻辑回归用于评估社会人口学特征与 FP 之间的关联。
在研究期间，ED 共接诊了 22679 名 16624 名成年患者。FPs 占总人口的 5.1%（95%置信区间 [CI] 4.8-5.5），占 ED 就诊总次数的 15.8%。FPs 的中位年龄为 46 岁（四分位间距 29-72），51.9%为男性。年龄>65 岁是 FP 的最强决定因素（调整性别后比值比 [OR] 2.33；95%CI 2.01-2.72）。与讲英语者相比，阿拉伯语者更有可能成为 FP（调整 OR 1.54；95%CI 1.28-1.86，调整年龄和性别），而讲普通话者则最不可能成为 FP（调整 OR 0.40；95%CI 0.27-0.59）。
FPs 占 ED 就诊次数的很大比例，但仅占 ED 患者的一小部分。我们的研究结果表明，确定为老年 FPs 提供针对性服务的方法可能会降低总体就诊率。语言群体与 FP 之间的差异突出了在制定针对性干预措施时考虑社会背景和文化的重要性。
