Designing services for frequent attenders to the emergency department: a characterisation of this population to inform service design.
Wong, Mai Luen
Clin Med (Lond)
Royal College of Physicians
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Jacob, R., Wong, M. L., Hayhurst, C., Watson, P., & Morrison, C. (2016). Designing services for frequent attenders to the emergency department: a characterisation of this population to inform service design.. Clin Med (Lond), 16 (4), 325-329. https://doi.org/10.7861/clinmedicine.16-4-325
Frequent attendance to the emergency department (ED) is a growing public health concern. Designing services for frequent attenders poses challenges, given the heterogeneous nature of this group. This was a two-part observational study identifying frequent attenders from ED records. The first stage studied trends and developed personas with emphasis on differentiating moderate frequent attenders (attending between 5 and 20 times per year) and extreme frequent attenders (attending more than 20 times). Stage 2 included a case note review of 100 consecutive frequent attenders. Results showed an increase in frequent attendance from 2.59% to 4.12% over 8 years. Moderate frequent attenders accounted for 97%. Of the 100 frequent attenders studied, 45% had medically unexplained symptoms (MUS), associated with younger age (p<0.001) but not with gender (p>0.05). In conclusion, the ED is a useful hub for identifying frequent attenders with MUS, particularly among moderate frequent attenders; service design for this group should consider a 'whole-systems approach' with integration between primary and secondary care, including specialist liaison psychiatry services where appropriate.
Humans, Retrospective Studies, Mental Health, Adolescent, Adult, Aged, Aged, 80 and over, Middle Aged, Patients, Emergency Service, Hospital, Female, Male, Young Adult, United Kingdom
External DOI: https://doi.org/10.7861/clinmedicine.16-4-325
This record's URL: https://www.repository.cam.ac.uk/handle/1810/311377
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