Frequent Users of Emergency Department Services: Gaps in Knowledge and a Proposed Research Agenda

摘要: Frequent use of emergency department (ED) services is often perceived to be a potentially preventable misuse resources. The underlying assumption that similar and more appropriate care can delivered outside EDs at lower cost. To reduce costs incentivize services, there have been efforts design interventions transition health utilization frequent users from other settings such as outpatient clinics. Many these succeeded in smaller trials, but wider remains elusive for varying reasons. There are also some fundamental problems with the all or even majority ED invoking reasons excessive use. These tenuous assumptions become evident when group compared less users. Specifically, tend high levels use, higher severity illness, older, fewer personal resources, chronically ill, present pain-related complaints, government insurance (Medicare Medicaid). Because unique characteristics population users, we propose research agenda aims increase understanding by: 1) creating an accepted categorization system 2) predicting which patients risk becoming remaining 3) implementing both ED- non-ED-based interventions, 4) conducting qualitative studies explore identify factors subject intervention specific differences among populations by condition, mental illness heart failure.