Characteristics of frequent presenters: An analysis of 1 year of data from an Irish Emergency Department

Introduction: Frequent presenters (FPs) to the Emergency Department (ED) have been studied heavily in international literature. Many studies suggest that maintaining services for this cohort of patients is wasteful and detracts from the needs of nonfrequent presenters. In this study we aim to describe the characteristics of FPs to the ED. We review data pertaining to frequent ED use, demographics of FPs, their preferred methods of arrival to the ED and their social living arrangements. FP's tend to rely heavily on other services as well as the ED and primary care. Methods: A systematic retrospective review of FPs attendance was performed. Results: FPs accounted for 3.9% (n=1231) of total ED attendance. The age of the FP population ranged from 19- 94 (Median = 45.5, SD 18.422). Increased ED attendance was positively associated with younger age groups. The age category accounting for the highest ED attendance was those aged between 19-35 years. From the 152 (100%) FPs, 50.7% (n=77) were males and 49.3% (n=75) were female. When the living arrangements of FPs were examined, 40.1% (n=61) lived with family, 37.5% (n=57) lived alone, 12.5% (n=19) resided in residential care while data on 9.9% (n=15) FPs was unknown. A Chi-squared analysis was computed to determine if age showed any significant correlation with living arrangements. The findings were not significant as X2 =2.148 (df3, p=0.542). Conclusions: FP's are positively associated with being young and often present with true medical needs. Many believe that frequent presentation is positively associated with free health care and living alone this is not the case. FP's are more likely to live with family and up to 17% of FP attendances have been as a result of primary care referral. FPs also present frequently to the ambulance service with almost 50% utilising the service for transport to the ED.