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

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dc.contributor.author Levola, Jonna M.
dc.contributor.author Sailas, Eila S.
dc.contributor.author Saamanen, Timo S.
dc.contributor.author Turunen, Leena M.
dc.contributor.author Thomson, Annika C.
dc.date.accessioned 2020-01-30T10:41:02Z
dc.date.available 2020-01-30T10:41:02Z
dc.date.issued 2019-11-21
dc.identifier.citation 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
dc.identifier.other PURE: 131013322
dc.identifier.other PURE UUID: c4d86e21-a3e7-443c-bed0-f67a034fcc7d
dc.identifier.other WOS: 000506192400029
dc.identifier.uri http://hdl.handle.net/10138/310666
dc.description.abstract 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. en
dc.format.extent 7
dc.language.iso eng
dc.relation.ispartof BMC Health Services Research
dc.rights cc_by
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject Emergency service
dc.subject Register-based cohort study
dc.subject Psychiatry
dc.subject Substance use
dc.subject Substance use disorder
dc.subject Mental health
dc.subject MENTAL-HEALTH
dc.subject GLOBAL BURDEN
dc.subject DISORDERS
dc.subject VISITS
dc.subject INDIVIDUALS
dc.subject PREVALENCE
dc.subject PROFILES
dc.subject DISEASE
dc.subject CARE
dc.subject 3141 Health care science
dc.title A register-based observational cohort study on persistent frequent users of emergency services in a Finnish emergency clinic en
dc.type Article
dc.contributor.organization HUS Psychiatry
dc.contributor.organization Clinicum
dc.contributor.organization Department of Psychiatry
dc.contributor.organization University of Helsinki
dc.contributor.organization Faculty of Medicine
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1186/s12913-019-4723-8
dc.relation.issn 1472-6963
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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