title: Frequent attenders at emergency departments: a linked-data population study of adult patients.
abstract: OBJECTIVE
  To examine the characteristics of adult patient attendances to emergency departments (EDs) in Perth hospitals by patients' frequency of attendance.
  
  
  METHODS
  A linked-data population study of adults (aged > or = 15 years) attending all nine Perth hospital EDs between 1 July 2000 and 31 December 2006.
  
  
  METHODS
  Proportion of frequent attenders (FAs; those attending five or more times annually); and demographic characteristics, mode of arrival at the ED, disposition (admission, transfer, discharge or death), urgency and clinical conditions by frequency of attendance.
  
  
  RESULTS
  There was a mean of 1.5 attendances per individual per year, resulting in 1 583 924 attendances by 663 309 individuals over the 6.5 years of the study. Most patients (97.6%) attended Perth EDs fewer than five times a year. The more frequently patients attended, the more likely they were to be male, middle-aged and late-middle-aged, have self-referred, have mental and behavioural disorders and alcohol intoxication, to not wait to be assessed, and to arrive by ambulance. The groups of patients attending between 5-9 and 10-19 times per year (97.4% of FAs) had more urgent conditions, more circulatory system disease and higher admission rates than all other patients.
  
  
  CONCLUSIONS
  Most FAs at Perth EDs present fewer than 20 times a year and have more serious and urgent illness than other patients, more often requiring inpatient services. A very small minority of patients (around 100 patients/year) attends 20 or more times a year, many with mental and behavioural disorders and alcohol intoxication not requiring hospital admission.
authors.affiliation: Discipline of Emergency Medicine, University of Western Australia, Perth, WA, Australia. George.Jelinek@gmail.com
authors.forename: George A
authors.initials: GA
authors.lastname: Jelinek
authors.forename: Moyez
authors.initials: M
authors.lastname: Jiwa
authors.forename: Nicholas P
authors.initials: NP
authors.lastname: Gibson
authors.forename: Ann-Maree
authors.initials: AM
authors.lastname: Lynch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003710:Demography; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014218:Triage / Q000706:statistics & numerical data; D014904:Western Australia; D055815:Young Adult