Scholarlink

Background <p>There is a&#xa0;subgroup of patients presenting to emergency departments (EDs) who frequently visit the ED. However, the various definitions of these so-called frequent users of the emergency department (FUED) in different healthcare systems make it difficult to compare the individual scientific studies and, thus, their impact on the ED. There is almost no data available for Germany. The aim of the present study was to characterize the collective of FUED at a&#xa0;tertiary care hospital in Germany and to classify them within the scope of the current reform of emergency care in Germany.</p> Methods <p>Retrospective observational study over a&#xa0;period of three full years (2021–2023). FUED was defined by year if ≥ 4 visits were available. The study examined the ICD&#xa0;10 diagnosis, urgency level, allocation, treatment level, and outcome.</p> Results <p>During the 3‑year observation period, there were a&#xa0;total of 127,154 visits, whereby 1705 emergency patients (1.67% of the total group) in at least one year had ≥ 4 visits per year. This group generated a&#xa0;total of 9117 visits during the observation period (7.17% of total visits). On average, patients walked in in 61.7% of cases, came by ambulance in 27.7% of cases, and by other means in 10.6% of cases. The distribution of patients’ Manchester triage system (MTS) urgency levels was on average “red” 0.9%, “orange” 15.0%, “yellow” 34.3%, “green” 43.4% and “blue” 6.5%. The care levels were divided into 60% outpatient, 35% normal ward and 5% intensive care unit. On average, 9.48 inpatient days were generated. The five most common ICD-10 diagnoses were mechanical complication due to urinary catheter (T83.0), urinary tract infection (N39.0), headache including facial pain (R51), paranoid schizophrenia (F20.0), and epilepsy (G40.2). The overall mortality rate for FUED in the observation period was 3.5% (<i>n</i> = 59).</p> Conclusion <p>The study shows for the first time the burden of FUED in a&#xa0;German emergency department. Furthermore, it shows that a&#xa0;significant proportion of FUED cases could have been treated by a&#xa0;general practitioner or intersectorally.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Charakterisierung von Notfallpatienten mit hoher Inanspruchnahme der zentralen Notaufnahme

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年12月18日

查看全文
  • I. Gräff,
  • B. Reichert,
  • M. Kogej,
  • M. Berger

摘要

Background

There is a subgroup of patients presenting to emergency departments (EDs) who frequently visit the ED. However, the various definitions of these so-called frequent users of the emergency department (FUED) in different healthcare systems make it difficult to compare the individual scientific studies and, thus, their impact on the ED. There is almost no data available for Germany. The aim of the present study was to characterize the collective of FUED at a tertiary care hospital in Germany and to classify them within the scope of the current reform of emergency care in Germany.

Methods

Retrospective observational study over a period of three full years (2021–2023). FUED was defined by year if ≥ 4 visits were available. The study examined the ICD 10 diagnosis, urgency level, allocation, treatment level, and outcome.

Results

During the 3‑year observation period, there were a total of 127,154 visits, whereby 1705 emergency patients (1.67% of the total group) in at least one year had ≥ 4 visits per year. This group generated a total of 9117 visits during the observation period (7.17% of total visits). On average, patients walked in in 61.7% of cases, came by ambulance in 27.7% of cases, and by other means in 10.6% of cases. The distribution of patients’ Manchester triage system (MTS) urgency levels was on average “red” 0.9%, “orange” 15.0%, “yellow” 34.3%, “green” 43.4% and “blue” 6.5%. The care levels were divided into 60% outpatient, 35% normal ward and 5% intensive care unit. On average, 9.48 inpatient days were generated. The five most common ICD-10 diagnoses were mechanical complication due to urinary catheter (T83.0), urinary tract infection (N39.0), headache including facial pain (R51), paranoid schizophrenia (F20.0), and epilepsy (G40.2). The overall mortality rate for FUED in the observation period was 3.5% (n = 59).

Conclusion

The study shows for the first time the burden of FUED in a German emergency department. Furthermore, it shows that a significant proportion of FUED cases could have been treated by a general practitioner or intersectorally.