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Frequent ED attendees could benefit from more specialist and personalised support

Healthcare data analysts Dr Foster tracked high-intensity users in England between June 2017 and March 2018

Healthcare data analysts Dr Foster tracked high-intensity users in England between June 2017 and March 2018


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Frequent attendees to emergency departments (EDs) may benefit from specialist care and a more personalised approach, analysis suggests.

The finding comes from healthcare data analysts Dr Foster, who reviewed over 13 million ED attendances in England between June 2017 and March 2018.

They tracked high-intensity users (HIUs) – patients who attend EDs ten or more times over a year.

Multiple attendances a day

Researchers found:

  • HIU attendances across the year totalled 522,312, but were made by only 31,492 people.
  • Despite accounting for only 0.4% of all patients in England during the data period, HIUs made up 4% of all ED attendances.
  • A number of individual HIUs visited EDs more than 235 times each, with some attending EDs multiple times in a single day.

The analysts also found that around 70% of HIUs live in more deprived areas, and smoking, drugs and alcohol all appear to play an important role in frequent ED use and are the most common reasons that HIUs are admitted to hospital.

HIUs also frequently attend EDs between the hours of 8pm and 6am, according to the data. 

Social factors

Dr Foster analysts state this could be due to other health and social services being inaccessible at these hours or because HIUs are affected by factors such as homelessness, loneliness, depression or anxiety.

The study’s authors conclude: ‘HIUs are patients whose ED visits have become a significant part of their life, and undoing this is not straightforward.

‘Wider societal factors undoubtedly have an impact on HIU behaviour. But, as has been illustrated by several successful initiatives, these can be addressed by focusing on individual human need.’

The authors suggested localised data analysis would further help NHS hospitals understand why HIUs are attending regularly, and how they can be managed in a better way.

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