A register-based observational cohort study on persistent frequent users of emergency services in a Finnish emergency clinic

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Pysyväisosoite

http://hdl.handle.net/10138/310666

Lähdeviite

Levola , J M , Sailas , E S , Saamanen , T S , Turunen , L M & Thomson , A C 2019 , ' A register-based observational cohort study on persistent frequent users of emergency services in a Finnish emergency clinic ' , BMC Health Services Research , vol. 19 , no. 1 , 881 . https://doi.org/10.1186/s12913-019-4723-8

Julkaisun nimi: A register-based observational cohort study on persistent frequent users of emergency services in a Finnish emergency clinic
Tekijä: Levola, Jonna M.; Sailas, Eila S.; Saamanen, Timo S.; Turunen, Leena M.; Thomson, Annika C.
Tekijän organisaatio: HUS Psychiatry
Clinicum
Department of Psychiatry
University of Helsinki
Faculty of Medicine
Päiväys: 2019-11-21
Kieli: eng
Sivumäärä: 7
Kuuluu julkaisusarjaan: BMC Health Services Research
ISSN: 1472-6963
DOI-tunniste: https://doi.org/10.1186/s12913-019-4723-8
URI: http://hdl.handle.net/10138/310666
Tiivistelmä: Background: The focus of emergency room (ER) treatment is on acute medical crises, but frequent users of ER services often present with various needs. The objectives of this study were to obtain information on persistent frequent ER service users and to determine reasons for their ER service use. We also sought to determine whether psychiatric diagnoses or ongoing use of psychiatric or substance use disorder treatment services were associated with persistent frequent ER visits. Methods: A cohort (n = 138) of persistent frequent ER service users with a total of 2585 ER visits during a two-year-period was identified. A content analysis was performed for 10% of these visits. Register data including International Classification of Primary Care 2 (ICPC-2) -codes and diagnoses were analyzed and multivariable models were created in order to determine whether psychiatric diagnoses and psychosocial reasons for ER service use were associated with the number of ER visits after adjusting for covariates. Results: Patients who were younger, had a psychiatric diagnosis and engaged in ongoing psychiatric and other health services, had more ER visits than those who were not. Having a psychiatric diagnosis was associated with the frequency of ER visits in the multivariable models after adjusting for age, gender and ongoing use of psychiatric or substance use disorder treatment services. Reasons for ER-service use according to ICPC-2 -codes were inadequately documented. Conclusions: Patients with psychiatric diagnoses are overrepresented in this cohort of persistent frequent ER service users. More efficient treatments paths are needed for patients to have their medical needs met through regular appointments.
Avainsanat: Emergency service
Register-based cohort study
Psychiatry
Substance use
Substance use disorder
Mental health
MENTAL-HEALTH
GLOBAL BURDEN
DISORDERS
VISITS
INDIVIDUALS
PREVALENCE
PROFILES
DISEASE
CARE
3141 Health care science
Vertaisarvioitu: Kyllä
Tekijänoikeustiedot: cc_by
Pääsyrajoitteet: openAccess
Rinnakkaistallennettu versio: publishedVersion


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