Table 4.
Factors associated with frequent ED use
| Frequent ED use (n = 2,075) | Single ED visits (n = 38,959) | OR (95% CI)1, 2 frequent ED use | OR (95% CI)1, 2 final model, frequent ED use* | |
|---|---|---|---|---|
|
Arrival time |
|
|
|
|
| Day shift |
888 (42.8) |
17,100 (43.9) |
Reference |
Reference |
| Evening shift |
812 (39.1) |
17,078 (43.8) |
1.02 (0.92, 1.13) |
1.00 (0.90, 1.10) |
| Night shift |
375 (18.1) |
4,781 (12.3) |
1.42 (1.24, 1.62) |
1.38 (1.21, 1.57) |
|
Arrival with ambulance |
339 (16.3) |
4,736 (12.2) |
0.91 (0.79, 1.05) |
- |
|
Self-referred |
1,108 (53.4) |
26,643 (68.4) |
0.70 (0.63, 0.78) |
0.70 (0.64, 0.77) |
|
Chief complaint [n (%)] |
|
|
|
|
| Limb problems |
235 (11.3) |
10,028 (25.7) |
0.48 (0.39, 0.59) |
0.46 (0.39, 0.54) |
| Wounds & local infections |
147 (7.1) |
4,977 (12.8) |
0.60 (0.48, 0.76) |
0.58 (0.48, 0.70) |
| Ear/Nose/Sore throat |
14 (0.7) |
895 (2.3) |
0.33 (0.19, 0.57) |
0.31 (0.18, 0.54) |
| Shortness of breath |
176 (8.5) |
1,376 (3.5) |
2.32 (1.84, 2.92) |
2.15 (1.79, 2.59) |
| Abdominal pain |
402 (19.4) |
3,208 (8.2) |
2.36 (1.94, 2.87) |
2.21 (1.92, 2.55) |
| Chest pain |
220 (10.6) |
2,784 (7.1) |
1.46 (1.16, 1.83) |
1.37 (1.16, 1.62) |
| Unwell patient |
126 (6.1) |
2.146 (5.5) |
1.08 (0.84, 1.38) |
- |
| Head ache & head injury |
56 (2.7) |
1,919 (4.9) |
0.56 (0.41, 0.77) |
0.52 (0.39, 0.69) |
| Psychiatric disorders |
110 (5.3) |
541 (1.4) |
3.36 (2.55, 4.41) |
3.03 (2.41, 3.83) |
| Back pain |
36 (1.7) |
705 (1.8) |
1.04 (0.72, 1.52) |
- |
| Severe trauma |
9 (0.4) |
753 (1.9) |
0.21 (0.11, 0.42) |
0.19 (0.10, 0.37) |
| Rashes |
21 (1.0) |
522 (1.3) |
0.82 (0.51, 1.31) |
- |
| Urinary tract problems |
60 (2.9) |
447 (1.1) |
2.61 (1.90, 3.59) |
2.46 (1.84, 3.27) |
| Worried parent |
2 (0.1) |
346 (0.9) |
0.12 (0.03, 0.47) |
0.11 (0.03, 0.45) |
| Eye problems |
10 (0.5) |
901 (2.3) |
0.24 (0.13, 0.46) |
0.23 (0.12, 0.43) |
| Pregnancy problems |
21 (1.0) |
412 (1.1) |
1.02 (0.64, 1.63) |
- |
| Other |
201 (9.7) |
2,901 (7.4) |
1.32 (1.06, 1.64) |
1.26 (1.05, 1.49) |
|
No triage |
229 (11.0) |
4,098 (10.5) |
- |
- |
|
Triage level |
|
|
|
|
| Immediate & very urgent |
403 (20.2) |
5,286 (14.0) |
Reference |
- |
| Urgent |
752 (37.7) |
11,749 (31.1) |
0.95 (0.83, 1.10) |
- |
| Standard & non-urgent |
840 (42.1) |
20,768 (54.9) |
1.01 (0.87, 1.19) |
- |
| No triage | 80 (3.9) | 1,156 (3.0) | - | - |
1Adjusted for other variables by logistic regression, OR >1 indicate an increased risk of frequent visit.
2Model based on 39,798 observations due to 1,236 missing values.
*Hosmer-Lemeshow test <0.001, AUC ROC 0.70 (0.69, 0.71).