Division of Emergency Medicine, University of Toronto, Toronto, Ontario, Canada.
Sunnybrook Health Sciences Center, Toronto, Ontario, Canada.
PLoS One. 2022 Sep 15;17(9):e0274622. doi: 10.1371/journal.pone.0274622. eCollection 2022.
There is little research on high frequency emergency department users (HEDU) in Sweden. We aim to determine the prevalence and costs of HEDU compared to non-HEDU at Örebro University Hospital (ÖUH). Additionally, we will determine the factors and outcomes associated with being a HEDU.
This was a retrospective, observational cohort study of ED patients presenting to ÖUH, Sweden between 2018-19. Analyses used electronic registry, ambulance, and cost data. The definition for HEDU was ≥4 visits/year. HEDUs were categorized further into Repeat, High and Super HEDU with 4-7, 8-18 and ≥19 visits/year, respectively. We used multivariable logistic regression to determine the adjusted odds ratios for factors and outcomes between HEDU and non-HEDU.
Of all ÖUH ED patients, 6.1% were HEDU and accounted for 22.4% of ED visits and associated costs. Compared to the mean cost of non-HEDU, the Repeat, High and Super HEDU were more costly by factors of 4, 8 and 27, respectively. The HEDUs were more likely to be male, self-referred, present with abdominal pain, arrive by ambulance, at night and from the Örebro municipal region. Super HEDU were more likely to be of adult age and assigned lower acuity scores. HEDU were more likely to be directed to the surgical zone, less likely to receive radiologic imaging or achieve a 4-hr time target. In contrast to the Repeat and High HEDU, Super HEDU were less likely to be admitted, but more likely to leave without being seen.
ÖUH has a HEDU population with associated factors and outcomes. They account for a substantial proportion of ED costs compared to non-HEDU.
瑞典对高频急诊科就诊者（HEDU）的研究较少。我们旨在确定 Örebro 大学医院（ÖUH）的 HEDU 与非 HEDU 的患病率和成本。此外，我们还将确定与成为 HEDU 相关的因素和结果。
这是一项回顾性观察性队列研究，研究对象为 2018-19 年期间在瑞典 ÖUH 急诊科就诊的患者。分析使用电子登记、救护车和成本数据。HEDU 的定义为≥4 次/年。HEDU 进一步分为重复、高和超级 HEDU，分别为 4-7、8-18 和≥19 次/年。我们使用多变量逻辑回归来确定 HEDU 和非 HEDU 之间的因素和结果的调整优势比。
在所有 ÖUH 急诊科患者中，6.1%为 HEDU，占急诊科就诊人数的 22.4%和相关费用的 22.4%。与非 HEDU 的平均费用相比，重复、高和超级 HEDU 的费用分别高出 4 倍、8 倍和 27 倍。HEDU 更可能是男性、自我转诊、出现腹痛、乘坐救护车、夜间和来自Örebro 市。超级 HEDU 更可能是成年年龄和分配较低的严重程度评分。HEDU 更有可能被送往外科区，不太可能接受放射影像学检查或达到 4 小时时间目标。与重复和高 HEDU 相比，超级 HEDU 入院的可能性较小，但离开而不被看到的可能性较大。
ÖUH 有一个 HEDU 人群，具有相关的因素和结果。与非 HEDU 相比，他们占急诊科成本的很大一部分。
