Shu Fen Lim1, Win Wah2, Yogeswary Pasupathi1, Susan Yap1, Mariko Siyue Koh3, Keng Leong Tan3, Cass Jwee Cheong Chay4, Marcus Eng Hock Ong5. 1. Department of Emergency Medicine, Singapore General Hospital, Singapore. 2. Centre for Infectious Disease Epidemiology and Research, Saw Swee Hock School of Public Health, National University of Singapore, Singapore. 3. Department of Respiratory & Critical Care Medicine, Singapore General Hospital, Singapore. 4. Operations and Performance Management, Singapore General Hospital, Singapore. 5. Department of Emergency Medicine, Singapore General Hospital, Singapore Office of Clinical Sciences, Duke-NUS Graduate Medical School, Singapore. Electronic address: marcus.ong.e.h@sgh.com.sg.
Abstract
BACKGROUND: Asthma has been reported as one of the main causes of frequent attendance to the emergency department (ED), and many of those visits are potentially preventable. Understanding the characteristics of frequent attender (FA) patients with asthmatic exacerbations will help to identify factors associated with frequent attendance and improve case management. The aim of this study is to describe the characteristics of FA who present multiple times to the ED for asthma exacerbations. METHODS: This study was a retrospective review of cases presented to Singapore General Hospital ED in 2010. Patients who attended the ED for 4 times or more with at least 1 visit attributable to asthma exacerbations in 2010 were included. They were then categorized as FA with multiple exacerbations (FAME) and those with fewer exacerbations. RESULTS: Of 105616 ED patients, 155 patients attending the ED in 2010 were identified as FA with asthma, and 26 (17%) of these patients were classified as FAME, resulting in 213 visits (45% of total visits). Compared with FA with fewer exacerbations group, FAME were more likely to be men (P = .002), unemployed (P < .000), bad debtors (P = .045), substance abusers (P = .022), previously known to medical social workers (P = .002), and were found to spend a longer amount of time in the ED (>6 hours) (P = .03). CONCLUSION: We found that a small number of FAME patients accumulated a large number of ED visits and spent a significantly longer time in the ED. This group tended to be males with social, financial, and addiction problems.
BACKGROUND:Asthma has been reported as one of the main causes of frequent attendance to the emergency department (ED), and many of those visits are potentially preventable. Understanding the characteristics of frequent attender (FA) patients with asthmatic exacerbations will help to identify factors associated with frequent attendance and improve case management. The aim of this study is to describe the characteristics of FA who present multiple times to the ED for asthma exacerbations. METHODS: This study was a retrospective review of cases presented to Singapore General Hospital ED in 2010. Patients who attended the ED for 4 times or more with at least 1 visit attributable to asthma exacerbations in 2010 were included. They were then categorized as FA with multiple exacerbations (FAME) and those with fewer exacerbations. RESULTS: Of 105616 ED patients, 155 patients attending the ED in 2010 were identified as FA with asthma, and 26 (17%) of these patients were classified as FAME, resulting in 213 visits (45% of total visits). Compared with FA with fewer exacerbations group, FAME were more likely to be men (P = .002), unemployed (P < .000), bad debtors (P = .045), substance abusers (P = .022), previously known to medical social workers (P = .002), and were found to spend a longer amount of time in the ED (>6 hours) (P = .03). CONCLUSION: We found that a small number of FAMEpatients accumulated a large number of ED visits and spent a significantly longer time in the ED. This group tended to be males with social, financial, and addiction problems.
Authors: Ting Hway Wong; Zheng Yi Lau; Whee Sze Ong; Kelvin Bryan Tan; Yu Jie Wong; Mohamad Farid; Melissa Ching Ching Teo; Alethea Chung Pheng Yee; Hai V Nguyen; Marcus Eng Hock Ong; N Gopalakrishna Iyer Journal: Cancer Med Date: 2018-08-17 Impact factor: 4.452
Authors: Luise Lago; Victoria Westley-Wise; Judy Mullan; Kelly Lambert; Rebekah Zingel; Thomas Carrigan; Wayne Triner; Kathy Eagar Journal: BMJ Open Date: 2019-06-22 Impact factor: 2.692