Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Nov 9;18(1):29.
doi: 10.1186/s12963-020-00237-w.

Frequent use of emergency departments and chronic conditions in ageing societies: a retrospective analysis based in Italy

Enrico di Bella  1 , Luca Gandullia  1 , Lucia Leporatti  2 , Walter Locatelli  3 , Marcello Montefiori  4 , Luca Persico  4 , Roberta Zanetti  3
Affiliations

Frequent use of emergency departments and chronic conditions in ageing societies: a retrospective analysis based in Italy

Enrico di Bella et al. Popul Health Metr. .

Abstract

Background: Most western countries are facing relevant demographic changes, and the percentage of older people is destined to rise in the next decades. This fact is likely to affect the sustainability of healthcare systems significantly, mainly due to the connected issue of chronicity.

Methods: In this paper, using an extensive and comprehensive administrative dataset, we analyse the phenomenon of frequent use of emergency departments (ED) in the oldest region in Europe (i.e. Liguria) over 4 years (2013-2016). Two alternative approaches are used to define categories of ED users based on the intensity and frequency of accesses and splitting patients into different age groups.

Results: Results allow identifying clinical and socio-demographic risk-factors connected to different levels of ED utilisation and highlight the influential role played by chronic conditions (particularly mental disorders, respiratory diseases) and by multiple chronic conditions.

Conclusions: The study aims at representing an informative tool to support policy-makers in setting proper policies addressed, on the one side, towards the potentially preventable frequent users and, on the other, towards those accessing due to complex medical conditions. The results can help in building a warning system to help general practitioners in the identification of potential frequent users and to develop preventive policies.

Keywords: Ageing; Emergency departments; Frequent use; Latent class model; Risk factors.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Definition of frequent users (FU) for adult (15+), paediatric (0–14) and older (65+) patients. The category of older patients (65+) is a subset of that of the adult patients (15+)
See this image and copyright information in PMC

References

    1. Akenroye AT, Thurm CW, Neuman MI, Alpern ER, Srivastava G, Spencer SP, et al. Prevalence and predictors of return visits to pediatric emergency departments. J Hosp Med. 2014;912:779–787. doi: 10.1002/jhm.2273. - DOI - PubMed
    1. Andrén KG, Rosenqvist U. Heavy users of an emergency department—a two year follow-up study. Soc Sci Med. 1987;257:825–831. doi: 10.1016/0277-9536(87)90040-2. - DOI - PubMed
    1. Bago d’Uva T. Latent class models for utilisation of health care. Health Econ. 2006;154:329–343. doi: 10.1002/hec.1112. - DOI - PubMed
    1. Blank FS, Li H, Henneman PL, Smithline HA, Santoro JS, Provost D, et al. A descriptive study of heavy emergency department users at an academic emergency department reveals heavy ED users have better access to care than average users. J Emerg Nurs. 2005;312:139–144. doi: 10.1016/j.jen.2005.02.008. - DOI - PubMed
    1. Brännäs K, Rosenqvist G. Semiparametric estimation of heterogeneous count data models. Eur J Oper Res. 1994;762:247–258. doi: 10.1016/0377-2217(94)90105-8. - DOI