title: Trends and characteristics of short-term and frequent representations to emergency departments: A population-based study from New South Wales, Australia.
abstract: OBJECTIVE
  The objective of this study is to describe the trends and characteristics of short-term and frequent representations to EDs in New South Wales, Australia.
  
  
  METHODS
  This was a retrospective analysis of a linked population-based registry of ED representations in New South Wales, conducted as part of the Demand for Emergency Services in Years 2010-2014 project. Trend analysis of unplanned representations to ED within 3 days of discharge from ED, readmission to an in-patient unit within 30 days of index in-patient admission from ED and demographic data and trends for frequent and very frequent ED presenters is discussed.
  
  
  RESULTS
  A total of 10 798 797 ED presentations were identified from 4 188 283 individual patients. Within 1 year, 48.9% of ED presentations had a previous presentation, and 4.9% had represented within 3 days of a previous presentation. The readmission rate within 30 days was 2.8%, the proportion of frequent (representing 5212 [0.1%] individual patients) and very frequent representations (representing 1186 [0.03%] individual patients) were 1.7% and 1.0%, respectively. The overall rate of representations within 3 days has decreased from 5.1% in 2010 to 4.7% in 2014 (P < 0.001). The rate of readmissions within 30 days has increased from 2.4% in 2010 to 3.1% in 2014 (P < 0.001).
  
  
  CONCLUSIONS
  In this population-based study, short-term representations were highest in the infant patient population, in-patient readmission rates were highest in the elderly and very frequent representations to ED were characterised by middle-aged patients with mental health or drug and alcohol related presentations.
authors.affiliation: Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.|Discipline of Emergency Medicine, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Dinh
authors.affiliation: Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.|School of Nursing, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Saartje
authors.initials: S
authors.lastname: Berendsen Russell
authors.affiliation: Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
authors.forename: Kendall J
authors.initials: KJ
authors.lastname: Bein
authors.affiliation: Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
authors.forename: Dane
authors.initials: D
authors.lastname: Chalkley
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Muscatello
authors.affiliation: Discipline of Emergency Medicine, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Paoloni
authors.affiliation: The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia.|School of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Ivers
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data* / Q000639:trends*; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D010343:Patient Admission / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D012042:Registries; D012189:Retrospective Studies
keywords: emergency department; frequent presenter; population; representation