Objective To investigate the demographic and service characteristics, motive for consultation, and disposition of adult frequent users (FUs) of the largest academic hospital in the Netherlands over a 5-year period. Patients and methods This retrospective study included all patients aged 18 years and older visiting the emergency department (ED) during a 5-year period (2009-2013). Frequent ED use was defined as having four or more visits to the ED during a year. Patient and service characteristics, motive for consultation, and disposition were explored. Results Frequent ED users represented 2% of all patients who visited the ED during 2009-2013 (8% of all ED consultations). On average, each FU visited the ED five times per year. Compared with nonfrequent users (NFUs), FUs were significantly less often self-referred, less frequently transported to the hospital by ambulance, received a lower urgency code upon arrival to the ED, and more often admitted to hospital than NFUs. Complaints related to the digestive system (19%), general complaints such as fever (18%), respiratory (10%), or cardiovascular problems (10%) were the main motive for consultations of the frequent ED users. Two percent of the FUs were serial FUs (FUs during 3 or more consecutive years). Conclusion Frequent use of the ED has been depicted as inappropriate use of these services. However, our study shows that FUs consist of a relatively small number of patients and that FUs suffer from chronic, and often, severe somatic illnesses that require specialized medical care.

Additional Metadata
Keywords emergency department, frequent user, public health
Persistent URL dx.doi.org/10.1097/MEJ.0000000000000314, hdl.handle.net/1765/108113
Journal European journal of emergency medicine : official journal of the European Society for Emergency Medicine
Citation
Bertoli Avella, A.M, Haagsma, J.A, van Tiel, S, Erasmus, V, Polinder, S, van Beeck, E.F, … Rood, P.P.M. (2017). Frequent users of the emergency department services in the largest academic hospital in the Netherlands: A 5-year report. European journal of emergency medicine : official journal of the European Society for Emergency Medicine, 24(2), 130–135. doi:10.1097/MEJ.0000000000000314