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- Title
Identifying Top Ten Frequent Attenders in a Tertiary Hospital in Singapore.
- Authors
Li Shi Melisa LOW; Chye Kiaw LOY; Shuli WONG; Lai Fong YIP; Qisha LIANG; Wee Sern Glen SIM; Kin Lee CHAN; Sok Yeong KOK; Peck Yoke Magdalene CHOW; Susan YAP; Yogeswary PASUPATHI; Marcus EH ONG
- Abstract
Background: A small number of patients are frequent attenders at the Emergency Department (ED) with multiple visits in a year and can contribute to ED overcrowding. Aim: To characterize the top ten frequent attenders (FAs) to the ED and explore the reasons for their multiple visits to better manage them. Method: A retrospective descriptive study from 1 January to 31 December 2010. The top ten unique patients with the highest number of visits to the ED during the study period were identified. Demographic information, medical history, social history and visit details were obtained. Results: The top 10 frequent attenders contributed to 821 (4.1%) of all ED visits in 1 year. Each patient contributed an average of 82 visits. Eight (80%) of the FAs were males with a mean age of 48 years. Six were Chinese, one Malay, and three Indians. All but one had chronic medical conditions; eight had social issues, with bad debt being the most common. 86.75% of the visits were independently judged by two clinical reviewers to be inappropriate. 50.2% of the visits were acute on chronic or chronic. Only 11.8% of the visits needed admission. 72.2% of the visits requiring admission were followed by revisits to the ED within 72 hours. Conclusion: Predominance of inappropriate visits by FA indicates that there is a need to right site care; high prevalence of social issues is evidence for the need to look into their frequent use of emergency care. Re-attendance at the DEM within 72 hours calls attention to the effectiveness of discharge process from inpatient care.
- Subjects
SINGAPORE; ASIANS; CHRONIC diseases; CLASSIFICATION; EMERGENCY medical services; LENGTH of stay in hospitals; HOSPITAL admission &; discharge; HOSPITAL emergency services; RESEARCH methodology; MEDICAL care use; MEDICAL emergencies; PATIENTS; SOCIAL problems; STATISTICS; MEDICAL triage; COMORBIDITY; SOCIOECONOMIC factors; DISCHARGE planning; RETROSPECTIVE studies; ACUTE diseases; DATA analysis software; DESCRIPTIVE statistics
- Publication
Singapore Nursing Journal, 2015, Vol 42, Issue 3, p22
- ISSN
0218-2475
- Publication type
Article