Background: Emergency Department (ED) crowding affects healthcare quality and access. In
Australia, ED presentations are increasing at approximately 3.4% per year. There is limited evidence
about frequent ED attenders from a longitudinal perspective, especially accounting for their
attendance at multiple facilities, a common occurrence in this patient group.
Aims: To investigate 10 years of longitudinal ED data from five EDs within a regional Australian Local
Health District, to determine: (i) whether there has been any change in the number frequent
attenders and their demographic and clinical profile; and (ii) whether frequent attenders remain so
over long periods.
Methods: An ‘index’ ED presentation was identified with the following 12-month window used to
identify frequent ED attendance. A threshold of 7 attendances per year was used to identify periods
of frequent ED attendance. Unlike in other studies, this approach was applied across a large number
of years to look at long-term frequent attendance patterns.
Results: Throughout the 10-year period, approximately 82% of frequent ED attenders, were so for
only 12 months, and were associated with injury, infections or illness of the ear, nose and throat. A
further 12% had two 12-month frequent periods. The remaining 6% were persistent frequent
attenders, more likely to be diagnosed with poisoning, psychiatric illness, alcohol/drug abuse, or
The research findings highlight two distinct groups, those who attend within a 12-month period,
versus those who attend frequently over a number of years. Appropriate interventions can be
developed to provide care based on each group’s needs.