Table 2.

Definition of frequent visitor from literature review

No	Examples of terms used	Conceptual definition of FV	Operationalization of the FV (examples of predictors of FV or FV are more likely to (be))
1	Patients with repeated admissions	NM	Attitude of helpless persons victimized by powerful external forces; place solution to their problems entirely in hands of physician; request for hospitalization and medication; demanding, provocative, and manipulative in communication with staff
2	Multiple visit; subsequent visits	NM	Displaying bizarre behavior during 1st visit; 92.2% receive same diagnosis as during 1st visit
3	Repeat patient visits	Return visit within 12 months after initial visit	Unemployed; need public assistance; have psychiatric history and/or, cognitive difficulties; severe primary diagnosis at initial visit
4	Non-repeaters Repeat users	- > 0 visits preceding index visit - > Group 1: 1 repeat visit within 6 months preceding index visit; Group 2: 2 or more repeat visit within 6 months preceding index visit	Group 1: Self-referred; single; have previous and current psychiatric treatment; schizophrenic; personality disorder; younger Group 2: Younger; unaccompanied; separated; comply more often with ambulatory follow-up; have poor rapport with staff in PER (no sig. Differences in sociodem and socioecon characteristics between NR and group 1 and 2)
5	Heavy users	Three or more admissions per year	Resemble young adult chronic patients; male, 17–35 years; schizophrenic; refuse outpatient care
6	Frequent repeaters	6 or more visits	Resident of catchment area; homicidal; self-injured; intoxicated during visits; absence of psychotherapist; have anxiety; self-referred; schizophrenic; have diagnosis of alcohol and/or substance abuse; borderline personality; concurrent psychiatric treatment; referred to outpatient treatment (no sign. Differences in sociodem. And socioecon. Characteristics)
7	Frequent repeaters Occasional repeaters Non-repeaters	- > 4–12 visits in a year - > 2–3 visits - > single visit	Schizophrenic; less often referred to outpatient clinics; visits after 4:30 p.m. and on weekends
8	Repeat users	4 groups: 1 visit, 2–4 visits, 5–10 visits and 11–162 visits	Male; younger; schizophrenic; suffer from major depression;, non-white; unmarried, unemployed; co-morbidity with substance abuse as 1st 2nd or 3rd diagnosis
9	Repeat visit; return visits	Repeat visit after 18 months	Previous psychiatric hospitalization; currently receiving outpatient treatment and not receiving aftercare
10	Repeated psychiatric referrals	NM	Male; younger; previous hospitalization; substance abuse disorder; inpatient treatment at end of visit
11	Repeat users	3–24 visits during the last 2 years of the follow-up	Male; living alone;, suffering from more serious diagnosis
12	Repeat users	Patients belonging to the upper tenth percentile of the emergency outpatient contacts, which in this study indicates at least three emergency contacts during the l-year follow-up	Location 1: male; divorced or unmarried; living with their parents; without their own housing; unemployed; age 25–44 Location 2: no sig.; differences in sociodem. Characteristics Have index contact with psychiatric services in outpatient care; self-referrals
13	Involuntary returnees and non-returnees	Return within 12 months	Spend more days in hospital after evaluation; psychotic disorder; more dangerous; less treatable; more insured; comply more with their referrals for treatment (no sign. Differences in sociodem. Characteristics),
14	Frequent visitors Infrequent visitors	- > 6 and more visits per calendar year - > 5 or less visits per calendar year	Motives for visits from staffs’ view: temporal pattern, weather, lunar variable
15	Involuntary returnees and non-returnees	Return within 12 months	See 13
16	Frequent visitors	6 or more visits in 12 months following index visit	Mon-adherent with treatment; admitted to inpatient hospital; homeless; rather drink than do drugs before visit; visit also other PER; have previous psychiatric hospitalization (no sign diff. in diagnosis) In interviews: report PER’s convenient location, no need for appointment, shelter, medication
17	Patients with recurrent utilization, repeated referrals	Patients with a history of PER visits	Female, mean age 37.3; lives with family; unemployed; have substance use disorders, personality disorders; noncompliant with aftercare; previous outpatient treatment
18	High utilizers	Three definitions: 1-patients with visits at least two standard deviations above the mean number of visits (selected because standard deviation units are the most common measure of variability); 2-patients with 6 or more visits in a single year (selection on the basis of previous studies); and 3- patients with 4 or more visits in one quarter (selected on the basis of the definition by the county).	Male; unemployed; enrolled in public mental health system; developmental disability; homeless; living dependently; have previous psychiatric hospitalization; schizophrenic
19	Frequent repeaters Occasional repeaters	- > 4 contacts or more during index period of 16 months - > 2 to 3 contacts during index period of 16 months	Male; younger; mean age 37.5; socially disabled; have psychosis; suffer from grief; self-referrals; lower welfare status
20	Patients who make multiple visits, Multiple visit patients	4 groups: 1 visit, 2 visits, 3–10 visits, 11+ visits	Younger; schizophrenic; have co-morbid psychiatric diagnosis; less dual diagnosis with substance abuse; more frequently placed under observation or hospitalized; unemployed
21	Multiple visit patients	intermediate group: 4–10 visits; heavy user group: 11+ visits	4–10 visits: schizophrenic; substance abuse; use of multiple services 11+ visits: schizophrenic; bipolar disorders; shorter time intervals between visits; use of multiple services
22	Repeat visitors	Repeat visit within six months after index visit	African American, show disruptive behavior; previous psychiatric hospitalization; suffer from diagnostic co-morbidity
23	Increase in utilization; utilization rates	NM	PER
24	Frequent visitors Occasional visitors	- > six or more visits in 6 years - > 2–5 visits in 6 years	Younger; single; homeless;, have non-affective psychotic disorders, schizophrenic, diagnostic variability
25	Frequent visitors	By nurses as persons who did not profit from psychiatric treatment and who could not mobilize sufficient resources in their psychosocial network to find alternatives to ER visits	Successful visits: relatively rapid with core problems and needs clearly identified; experience of reciprocity and rapport Difficult visits: nurses are not able to deal swiftly with visitor or/and visitor did not profit from treatment, discrepancies between assistance offered at PER and visitors’ own perception of their needs; not all FV were classified as difficult
26	Frequent visitor	5 visits or more per year	Schizophrenic; male; living in sheltering housing In interviews: final resort for help in an unbearable situation; integrated and valued part of social network
27	Recurrent visits (frequent visitors)	3 visits or more per year	Personality disorder (no sociodemographic predictors were found)
28	Repeat use of PES, frequent users, high utilizers, non-frequent users	Repeat use within 90 days	In interviews: instability in domains like housing, employment, finances, interpersonal relationships, formal treatment services, use of medication, living with substance abuse etc.
29	Frequent users	3 visits or more in a year	Implementation of a model to decrease use of PER and increase use of outpatient services

FV Frequent visitors

NM not mentioned

NR Non-Repeater