Characteristics of High Utilizer Patients in the Emergency Department at a University Hospital in the Kingdom of Bahrain

J Emerg Med. 2025 Jan:68:100-108. doi: 10.1016/j.jemermed.2024.07.003.

Abstract

Background: Emergency departments (EDs) around the world are facing a crippling crisis of overcrowding, a complex problem caused by a variety of factors. One contributing factor is the overutilization of EDs by patients with frequent visits.

Objective: This study aims at measuring the prevalence of this phenomenon and better understanding the characteristics of high utilizers.

Methods: A retrospective review was conducted in a tertiary care teaching hospital, for patients aged 14 years and above during the year 2022. The definition of a high utilizer is set as any patient that fits the inclusion criteria with four or more visits to the ED during 1 year.

Results: The prevalence of high utilizers in our ED is 3.9%, accounting for 12.1% of visits in 2022, where 135 was the highest number of visits made by one patient. Visits mostly consisted of level 3, Yellow (48.9%) and level 4, Green (42.8%) triage. The top three chief complaints were sore throat (16.8%), unwell adult (15.1%), and abdominal pain (12.8%). The total length of stay was 3.6 ± 3.2 h in the ED. Time of arrival was observed; 23.9% presented at night, 37.8% in the morning, and 38.8% in the evening.

Conclusions: The prevalence rate of high utilizers was found to be 3.9% in our study, falling within the range based on literature. Due to the parallel issues raised by many studies, the importance of developing convenient corrective strategies and conducting further national-based studies to get better insight of high utilizers is required.

Keywords: ED; EMD; Emergency departments; Frequent flyers; Frequent utilizers; Health care utilization; High utilizers.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bahrain / epidemiology
  • Crowding
  • Emergency Service, Hospital* / organization & administration
  • Emergency Service, Hospital* / statistics & numerical data
  • Female
  • Hospitals, University* / organization & administration
  • Hospitals, University* / statistics & numerical data
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Triage / methods
  • Triage / statistics & numerical data