Demographic and health care utilization characteristics of people who made frequent visits to the emergency department in Alberta
| Characteristic | Apr. 1, 2011–Mar. 31, 2012 | Apr. 1, 2012–Mar. 31, 2013 | Apr. 1, 2013–Mar. 31, 2014 | Apr. 1, 2014–Mar 31, 2015 | Apr. 1, 2015–Mar. 31, 2016 |
|---|---|---|---|---|---|
| Emergency department visit characteristics (NACRS metadata) | |||||
| No. of patients | 98840 | 102781 | 103711 | 105047 | 102027 |
| No. of visits per patient, median (IQR) | 5 (4–7) | 5 (4–7) | 5 (4–7) | 5 (4–7) | 5 (4–7) |
| No. of emergency department visits | 680740 | 699962 | 700347 | 704256 | 690330 |
| Arrival by ambulance, n (%) | |||||
| Air ambulance | 433 (0.1) | 398 (0.1) | 403 (0.1) | 501 (0.1) | 443 (0.1) |
| Air and ground ambulance | 767 (0.1) | 766 (0.1) | 649 (0.1) | 650 (0.1) | 470 (0.1) |
| Ground ambulance | 79141 (11.6) | 85515 (12.2) | 89108 (12.7) | 94726 (13.5) | 97925 (14.2) |
| No ambulance | 600399 (88.2) | 613283 (87.6) | 610187 (87.1) | 608379 (86.4) | 591492 (85.7) |
| Triage level (CTAS), n (%) | |||||
| 1 (resuscitation) | 1649 (0.2) | 2195 (0.3) | 2570 (0.4) | 3153 (0.4) | 3109 (0.5) |
| 2 (emergent) | 50532 (7.4) | 57895 (8.3) | 63947 (9.1) | 70898 (10.1) | 77985 (11.3) |
| 3 (urgent) | 177861 (26.1) | 190429 (27.2) | 193700 (27.7) | 209718 (29.8) | 221905 (32.1) |
| 4 (less urgent) | 240461 (35.3) | 242305 (34.6) | 248299 (35.5) | 249633 (35.4) | 239741 (34.7) |
| 5 (nonurgent) | 159539 (23.4) | 159704 (22.8) | 153945 (22.0) | 134544 (19.1) | 116670 (16.9) |
| Unknown | 48740 (7.2) | 45577 (6.5) | 35774 (5.1) | 34405 (4.9) | 29364 (4.3) |
| Not available | 1958 (0.3) | 1857 (0.3) | 2112 (0.3) | 1905 (0.3) | 1556 (0.2) |
| Top 5 ICD-10-CA primary diagnosis chapters, n (%) | |||||
| 1 | General health status 176635 (25.9) | General health status 174778 (25.0) | General health status 170621 (24.4) | General health status 162792 (23.1) | General health status 155595 (22.5) |
| 2 | Abnormal clinical findings 97120 (14.3) | Abnormal clinical findings 100856 (14.4) | Abnormal clinical findings 104234 (14.9) | Abnormal clinical findings 108528 (15.4) | Abnormal clinical findings 109645 (15.9) |
| 3 | Injury and poisoning 83836 (12.3) | Injury and poisoning 88125 (12.6) | Injury and poisoning 89318 (12.8) | Injury and poisoning 90696 (12.9) | Injury and poisoning 88772 (12.9) |
| 4 | Respiratory 52425 (7.7) | Respiratory 55897 (8.0) | Respiratory 53191 (7.6) | Respiratory 54796 (7.8) | Respiratory 50195 (7.3) |
| 5 | Musculoskeletal 39632 (5.8) | Musculoskeletal 40971 (5.9) | Musculoskeletal 41019 (5.9) | Digestive 40888 (5.8) | Mental and behavioural 40297 (5.8) |
| Visit disposition, n (%) | |||||
| Discharged | 584541 (85.9) | 597069 (85.3) | 593365 (84.7) | 590099 (83.8) | 577751 (83.7) |
| Transferred or admitted | 71150 (10.4) | 75501 (10.8) | 77497 (11.0) | 80386 (11.5) | 82193 (11.9) |
| Left against medical advice | 24857 (3.7) | 27208 (3.9) | 29274 (4.2) | 33524 (4.8) | 30174 (4.4) |
| Died | 192 (0.0) | 184 (0.0) | 211 (0.0) | 247 (0.0) | 212 (0.0) |
| Hospitalization characteristics (DAD metadata) | |||||
| No. of admissions | 66843 | 70069 | 72127 | 73466 | 75014 |
| No. of admissions per patient, median (IQR) | 1 (1–2) | 1 (1–2) | 1 (1–2) | 1 (1–2) | 1 (1–2) |
| Top 5 ICD-10 primary diagnosis chapters simplified, n (%) | |||||
| 1 | Mental and behavioural 6736 (10.1) | Mental and behavioural 7244 (10.3) | Mental and behavioural 7824 (10.8) | Mental and behavioural 8143 (11.1) | Mental and behavioural 8608 (11.5) |
| 2 | Circulatory 8328 (12.5) | Circulatory 8734 (12.5) | Circulatory 8865 (12.3) | Circulatory 9319 (12.7) | Circulatory 9415 (12.6) |
| 3 | Respiratory 7196 (10.8) | Respiratory 7906 (11.3) | Respiratory 7957 (11.0) | Respiratory 8778 (11.9) | Respiratory 8679 (11.6) |
| 4 | Digestive 8945 (13.4) | Digestive 9186 (13.1) | Digestive 9534 (13.2) | Digestive 9828 (13.4) | Digestive 9910 (13.2) |
| 5 | Injury and poisoning 6966 (10.4) | Injury and poisoning 7310 (10.4) | Injury and poisoning 7556 (10.5) | Injury and poisoning 7823 (10.6) | Injury and poisoning 7904 (10.5) |
| Mental health hospitalization–related characteristics (HMHDB metadata) | |||||
| No. of mental health–related admissions | 7835 | 8393 | 9103 | 9292 | 9798 |
| No. of mental health–related admissions per patient, median (IQR) | 1 (1–2) | 1 (1–2) | 1 (1–2) | 1 (1–2) | 1 (1–2) |
| Diagnosis category, n (%) | |||||
| Mood disorder | 1806 (23.1) | 1751 (20.9) | 1823 (20) | 1789 (19.3) | 1854 (18.9) |
| Schizophrenic and psychotic disorder | 1335 (17.0) | 1434 (17.1) | 1512 (16.6) | 1294 (13.9) | 1297 (13.2) |
| Substance-related disorder | 2268 (28.9) | 2691 (32.1) | 3095 (34) | 3351 (36.1) | 3570 (36.4) |
| Organic disorder | 860 (11.0) | 875 (10.4) | 906 (10.0) | 919 (9.9) | 986 (10.1) |
| Other mental health disorder | 855 (10.9) | 909 (10.8) | 971 (10.7) | 1 122 (12.1) | 1142 (11.7) |
| Anxiety disorder | 353 (4.5) | 403 (4.8) | 427 (4.7) | 415 (4.5) | 459 (4.7) |
| Personality disorder | 337 (4.3) | 310 (3.7) | 342 (3.8) | 358 (3.9) | 446 (4.6) |
| Non–mental health disorder | 21 (0.3) | 20 (0.2) | 27 (0.3) | 44 (0.5) | 44 (0.4) |
Note: CTAS = Canadian Triage and Acuity Scale, DAD = Discharge Abstract Database, HMHDB = Hospital Mental Health Database, ICD-10-CA = International Statistical Classification of Diseases and Related Health Problems, 10th revision, Canadian version, IQR = interquartile range, NACRS = National Ambulatory Care Reporting System.