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Patients Who Use Multiple EDs: Quantifying the Degree of Overlap between ED Populations

  • Author(s): Fertel, Baruch S.
  • Hart, Kimberly W.
  • Lindsell, Christopher J.
  • Ryan, Richard J.
  • Lyons, Michael S.
  • et al.
Abstract

Introduction: The degree to which individual patients use multiple emergency departments (EDs)is not well-characterized. We determined the degree of overlap in ED population between threegeographically proximate hospitals.

Methods: This retrospective cohort study reviewed administrative hospital records from 2003 to2007 for patients registered to receive ED services at an urban academic, urban community, andsuburban community ED located within 10 miles of one another. We determined the proportion whosought care at multiple EDs and secondarily characterized patterns of repeat encounters.

Results: There were 795,176 encounters involving 282,903 patients. There were 89,776 (31%)patients with multiple encounters to a single ED and 39,920 (14%) patients who sought care frommultiple EDs. The 39,920 patients who sought care from multiple EDs generated 185,629 (23%)of all encounters. Patients with repeat encounters involving multiple EDs were more likely to befrequent or highly frequent users (30%) than patients with multiple encounters to a single ED (14%).

Conclusion: While only 14% of patients received care from more than one ED, they wereresponsible for a quarter of ED encounters. Patients who use multiple EDs are more oftenfrequent or highly frequent users than are repeat ED visitors to the same ED. Overlap between ED populations is sufficient to warrant consideration by multiple domains of research, practice, andpolicy. [West J Emerg Med. 2015;16(2):229–233.]

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