Article Figures & Tables
Tables
- Table 1:
Demographic and health care utilization characteristics of people who made frequent visits to the emergency department in Ontario
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 435334 446954 451568 465949 477647 No. of visits per patient, median (IQR) 4 (3–5) 4 (3–5) 4 (3–5) 4 (3–5) 4 (3–5) No. of emergency department visits 2004975 2053609 2079281 2149965 2213161 Arrival by ambulance, n (%) Air ambulance 486 (0) 422 (0) 369 (0) 459 (0) 411 (0) Air and ground ambulance 978 (0) 1119 (0.1) 1054 (0.1) 1283 (0.1) 1315 (0.1) Ground ambulance 352171 (17.6) 376214 (18.3) 397811 (19.1) 428368 (19.9) 446762 (20.2) No ambulance 1651340 (82.4) 1675854 (81.6) 1680047 (80.8) 1719855 (80.0) 1764673 (79.7) Triage level (CTAS), n (%) 1 (resuscitation) 13123 (0.7) 14229 (0.7) 16599 (0.8) 18759 (0.9) 20796 (0.9) 2 (emergent) 332219 (16.6) 361122 (17.6) 402949 (19.4) 435122 (20.2) 458014 (20.7) 3 (urgent) 849844 (42.4) 896673 (43.7) 931616 (44.8) 975875 (45.4) 1012638 (45.8) 4 (less urgent) 648833 (32.4) 634937 (30.9) 597374 (28.7) 588964 (27.4) 593436 (26.8) 5 (nonurgent) 151140 (7.5) 137432 (6.7) 121391 (5.8) 114988 (5.3) 113565 (5.1) Unknown 8040 (0.4) 7607 (0.4) 7615 (0.4) 14344 (0.7) 12344 (0.6) Not available 1776 (0.1) 1609 (0.1) 1737 (0.1) 1913 (0.1) 2368 (0.1) Top 5 ICD-10-CA primary diagnosis chapters, n (%) 1 Respiratory
162000 (8.1)Respiratory
170897 (8.3)Respiratory
160762 (7.7)Respiratory
180688 (8.4)Respiratory
178433 (8.1)2 Musculoskeletal
136297 (6.8)Musculoskeletal
137722 (6.7)Musculoskeletal
140076 (6.7)Musculoskeletal
146490 (6.8)Musculoskeletal
154688 (7.0)3 Abnormal clinical findings
412 928 (20.6)Abnormal clinical findings
427536 (20.8)Abnormal clinical findings
442744 (21.3)Abnormal clinical findings
458415 (21.3)Abnormal clinical findings
473430 (21.4)4 Injury and poisoning
285123 (14.2)Injury and poisoning
294076 (14.3)Injury and poisoning
300560 (14.5)Injury and poisoning
305651 (14.2)Injury and poisoning
320186 (14.5)5 General health status
215204 (10.7)General health status
212930 (10.4)General health status
210348 (10.1)General health status
205890 (9.6)General health status
202791 (9.2)Visit disposition, n (%) Discharged 1620491 (80.8) 1658247 (80.7) 1679353 (80.8) 1732802 (80.6) 1778194 (80.4) Transferred or admitted 290321 (14.5) 306710 (14.8) 315618 (15.2) 326049 (15.2) 337594 (15.2) Left against medical advice 93003 (4.6) 87501 (4.3) 83169 (4) 89909 (4.2) 96255 (4.3) Died 1160 (0.1) 1151 (0.1) 1141 (0.1) 1205 (0.1) 1118 (0) Hospitalization characteristics (DAD metadata) No. of admissions 255202 268573 276307 284787 292411 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 Circulatory
45573 (17.9)Circulatory
46974 (17.5)Circulatory
48260 (17.5)Circulatory
49267 (17.3)Circulatory
50029 (17.1)2 Respiratory
9491 (11.6)Respiratory
32452 (12.1)Respiratory
32177 (11.6)Respiratory
36479 (12.8)Respiratory
35749 (12.2)3 Digestive
36263 (14.2)Digestive
37876 (14.1)Digestive
39235 (14.2)Digestive
38983 (13.7)Digestive
41150 (14.1)4 Abnormal clinical findings
26679 (10.5)Abnormal clinical findings
27441 (10.2)Abnormal clinical findings
27767 (10.0)Abnormal clinical findings
27771 (9.8)Abnormal clinical findings
27636 (9.5)5 Injury and poisoning
24054 (9.4)Injury and poisoning
25134 (9.4)Injury and poisoning
26302 (9.5)Injury and poisoning
26175 (9.2)Injury and poisoning
27506 (9.4)Mental health hospitalization–related characteristics (HMHDB metadata) No. of mental health–related admissions 37100 38282 39030 39913 42708 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 11513 (31.0) 11563 (30.2) 11148 (28.6) 11565 (29.0) 12038 (28.2) Schizophrenic and psychotic disorder 9355 (25.2) 9362 (24.5) 9797 (25.1) 9008 (22.6) 9192 (21.5) Substance-related disorder 7097 (19.1) 7200 (18.8) 7484 (19.2) 7849 (19.7) 8758 (20.5) Organic disorder 3628 (9.8) 4275 (11.2) 4615 (11.8) 4974 (12.5) 5721 (13.4) Other mental health disorder 2679 (7.2) 2863 (7.5) 2898 (7.4) 2988 (7.5) 3187 (7.5) Anxiety disorder 1412 (3.8) 1480 (3.9) 1467 (3.8) 1647 (4.1) 1661 (3.9) Personality disorder 1245 (3.4) 1353 (3.5) 1388 (3.6) 1672 (4.2) 1918 (4.5) Non–mental health disorder 125 (0.3) 133 (0.3) 175 (0.4) 175 (0.4) 183 (0.4) Unknown disorder (not available) 46 (0.1) 53 (0.1) 58 (0.1) 35 (0.1) 50 (0.1) 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.
- Table 2:
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.
- Table 3:
Patient and health care utilization characteristics of people who make frequent emergency department visits and controls (Apr. 1, 2015, to Mar. 31, 2016), by province
Characteristic Ontario Alberta Frequent emergency department visits Controls Frequent emergency department visits Controls Patient characteristics (NACRS metadata) No. of patients 477647 1711848 102027 404111 Gender, n (%) Female 264731 (55.4) 896281 (52.4) 56417 (55.3) 204986 (50.7) Male 212908 (44.6) 815550 (47.6) 45610 (44.7) 199125 (49.3) Other 6 (0.0) 9 (0.0) 0 (0.0) 0 (0.0) Undifferentiated 2 (0.0) 8 (0.0) 0 (0.0) 0 (0.0) Age, yr, median (IQR) 52 (33–70) 49 (33–64) 46 (30–64) 43 (30–59) Rural or urban, n (%) Rural 98098 (20.5) 273212 (16.0) 35178 (34.5) 71432 (17.7) Urban 377318 (79.0) 1435081 (83.8) 65429 (64.1) 330834 (81.9) Not available 2231 (0.5) 3555 (0.2) 1420 (1.4) 1845 (0.4) No. of visits per patient, median (IQR) 4 (3–5) 1 (1–1) 5 (4–7) 1 (1–2) Emergency department visit characteristics (NACRS metadata) Total number of emergency department visits 2213161 2106899 690330 562922 Arrival by ambulance, n (%) Air ambulance 411 (0.0) 236 (0.0) 443 (0.1) 349 (0.1) Air and ground ambulance 1315 (0.1) 591 (0.0) 470 (0.1) 165 (0.0) Ground ambulance 446762 (20.2) 310071 (14.7) 97925 (14.2) 66255 (11.8) No ambulance 1764673 (79.7) 1796001 (85.2) 591492 (85.7) 496153 (88.1) Triage level (CTAS), n (%) 1 (resuscitation) 20796 (0.9) 19316 (0.9) 3109 (0.5) 3192 (0.6) 2 (emergent) 458014 (20.7) 418003 (19.8) 77985 (11.3) 81244 (14.4) 3 (urgent) 1012638 (45.8) 967356 (45.9) 221905 (32.1) 215251 (38.2) 4 (less urgent) 593436 (26.8) 638023 (30.3) 239741 (34.7) 206498 (36.7) 5 (nonurgent) 113565 (5.1) 60197 (2.9) 116670 (16.9) 46307 (8.2) Unknown 12344 (0.6) 2695 (0.1) 29364 (4.3) 9957 (1.8) Not available 2368 (0.1) 1309 (0.1) 1556 (0.2) 473 (0.1) Visit disposition, n (%) Discharged 1778194 (80.3) 1818664 (86.3) 577751 (83.7) 479990 (85.3) Transferred or admitted 337594 (15.3) 221797 (10.5) 82193 (11.9) 61864 (11.0) Left against medical advice 96255 (4.3) 63833 (3.0) 30174 (4.4) 20513 (3.6) Died 1118 (0.1) 2605 (0.1) 212 (0.0) 555 (0.1) Hospitalization characteristics (DAD metadata) No. of patients with at least 1 admission, (%) 157965 (33.1) 186498 (10.9) 38464 (37.7) 50348 (12.5) No. of admissions 292411 211916 75014 59728 ICD-10 primary problem chapter among admissions, n (%) Infectious diseases (I) 13966 (4.8) 8194 (3.9) 2624 (3.5) 1738 (2.9) Neoplasms (II and III) 18315 (6.3) 11092 (5.2) 3439 (4.6) 2778 (4.7) Endocrine (IV) 12236 (4.2) 5688 (2.7) 3028 (4.0) 1543 (2.6) Mental and behavioural (V) 10187 (3.5) 4202 (2.0) 8608 (11.5) 4754 (8.0) Neurologic (VI) 6983 (2.4) 4583 (2.2) 1655 (2.2) 1264 (2.1) Eye and ear (VII and VIII) 836 (0.3) 1114 (0.5) 242 (0.3) 385 (0.6) Circulatory (IX) 50029 (17.1) 45727 (21.6) 9415 (12.6) 9660 (16.2) Respiratory (X) 35749 (12.2) 20607 (9.7) 8679 (11.6) 5353 (9.0) Digestive (XI) 41150 (14.1) 34488 (16.3) 9910 (13.2) 8722 (14.6) Skin (XII) 5120 (1.8) 2015 (1.0) 1653 (2.2) 645 (1.1) Musculoskeletal (XIII) 8113 (2.8) 4757 (2.2) 1975 (2.6) 1352 (2.3) Genitourinary (XIV) 19100 (6.5) 10740 (5.1) 4695 (6.3) 3563 (6.0) Pregnancy (XV) 5417 (1.9) 6688 (3.2) 2848 (3.8) 2853 (4.8) Perinatal (XVI) 0 (0.0) 1 (0.0) 2 (0.0) 0 (0.0) Congenital (XVII) 124 (0.0) 110 (0.1) 44 (0.1) 47 (0.1) Abnormal clinical findings (XVIII) 27636 (9.5) 15969 (7.5) 5523 (7.4) 3374 (5.6) Injury and poisoning (XIX) 27506 (9.4) 27818 (13.1) 7904 (10.5) 9135 (15.3) General health status (XXI) 9944 (3.4) 8122 (3.8) 2770 (3.7) 2560 (4.3) Not available 0 (0.0) 1 (0.0) 0 (0.0) 2 (0.0) Alcohol-related diagnoses among admissions, n (%) Yes 4000 (1.4) 1402 (0.7) 2482 (3.3) 771 (1.3) No 288411 (98.6) 210514 (99.3) 72532 (96.7) 58957 (98.7) Continuing care (CCRS metadata) Number of patients with continuing care use, n (%) 19512 (4.1) 20307 (1.2) 1140 (1.1) 1730 (0.4) Home care (HCRS metadata) Number of patients with home care use, n (%) 91582 (19.2) 111368 (6.5) 15901 (15.6) 20439 (5.1) Mental health hospitalization–related characteristics (HMHDB metadata) No. of patients with at least 1 mental health–related admission (%) 25555 (5.4) 16048 (0.9) 5913 (5.8) 4677 (1.2) Homelessness status among patients with at least 1 mental health–related admission, n (%) Home 1246 (4.9) 247 (1.5) 338 (5.7) 80 (1.7) No. of mental health–related admissions 42708 18243 9798 5653 Diagnosis category among mental health–related admissions n (%) Mood disorder 12038 (28.2) 5654 (31.0) 1854 (18.9) 1379 (24.4) Substance-related disorder 8758 (20.5) 2600 (14.3) 3570 (36.4) 1086 (19.2) Schizophrenic and psychotic disorder 9192 (21.5) 3973 (21.8) 1297 (13.2) 1118 (19.8) Organic disorder 5721 (13.4) 3518 (19.3) 986 (10.1) 1063 (18.8) Other mental health disorder 3187 (7.5) 1533 (8.4) 1142 (11.7) 658 (11.6) Anxiety disorder 1661 (3.9) 618 (3.4) 459 (4.7) 217 (3.8) Personality disorder 1918 (4.5) 234 (1.3) 446 (4.6) 88 (1.6) Non–mental health disorder 183 (0.4) 86 (0.5) 44 (0.4) 44 (0.8) Unknown disorder or not available 50 (0.1) 27 (0.1) 0 (0.0) 0 (0.0) Note: CCRS = Continuing Care Reporting System, CTAS = Canadian Triage and Acuity Scale, DAD = Discharge Abstract Database, HCRS = Home Care Reporting System, HMHDB = Hospital Mental Health Database, IQR = interquartile range, ICD-10-CA = International Statistical Classification of Diseases and Related Health Problems, 10th revision, Canadian version, NACRS = National Ambulatory Care Reporting System.
- Table 4:
Cluster analysis and subgroup characterization among people who made frequent emergency department visits from Apr. 1, 2013, to Mar. 31, 2014 — Ontario
Characteristic Subgroup 1 (“Short duration”) Subgroup 2 (“Older patients”) Subgroup 3 (“Young mental health”) Subgroup 4 (“Injury”) Subgroup characteristics (clustering variables) No. of patients 34116 74995 49167 292704 Age, yr, median (IQR) 49 (32–64) 69 (54–80) 45 (29–63) 47 (30–65) No. of visits to the emergency department, median (IQR) 2 (1–3) 3 (2–4) 6 (4–8) 2 (1–3) Charlson Comorbidity Index, median (IQR) 0 (0–0) 1 (1–1) 0 (0–0) 0 (0–0) No. of different discharge diagnosis chapters, median (IQR) 2 (2–2) 3 (2–4) 5 (4–6) 3 (2–3) No. of months in the year that patients visited the emergency department, median (IQR) 1 (1–2) 3 (3–4) 6 (5–7) 3 (2–3) Regularity index, median (IQR) 1 (0.8–1) 0.9 × 10−7 (0.6 × 10−7 to 6.8 × 10−5) 1.3 × 10−7 (0.9 × 10−7 to 2.2 × 10−7) 0.9 × 10−7 (0.5 × 10−7 to 1.2 × 10−4) Patient characteristics (NACRS metadata) Gender, n (%) Female 16875 (49.5) 39575 (52.8) 29136 (59.3) 166034 (56.7) Male 17241 (50.5) 35420 (47.2) 20030 (40.7) 126667 (43.3) Other 0 (0.0) 0 (0.0) 0 (0.0) 1 (0.0) Undifferentiated 0 (0.0) 0 (0.0) 1 (0.0) 1 (0.0) Not available 0 (0.0) 0 (0.0) 0 (0.0) 1 (0.0) Rural or urban, n (%) Rural 7361 (21.6) 15945 (21.3) 10957 (22.3) 58949 (20.1) Urban 26669 (78.2) 58923 (78.6) 37485 (76.2) 232647 (79.5) Emergency department visit characteristics (NACRS metadata) No. of emergency department visits 113990 386011 563397 1187131 Top 5 ICD-10 emergency department primary diagnoses, n (%) 1 Drug therapies
13082 (11.5)COPD
23782 (4.2)Abdominal pain
23782 (4.2)Abdominal pain
46055 (3.9)2 Abdominal pain
3944 (3.5)Asthma
15192 (2.7)Drug therapies
15192 (2.7)UTI
37335 (3.1)3 Dressings
3151 (2.8)Pneumonia
15025 (2.7)UTI
15025 (2.7)Chest pain
31801 (2.7)4 Cellulitis of the lower limb
3107 (2.7)Bronchitis
12552 (2.2)Chest pain
12552 (2.2)Drug therapies
26497 (2.2)5 Cellulitis of the upper limb
2021 (1.8)CHF
10268 (1.8)Alcohol intoxication
10268 (1.8)Cellulitis of the lower limb
16941 (1.4)Visit disposition, n (%) Discharged 92928 (81.5) 266750 (69.1) 455419 (80.8) 1003316 (84.5) Left against medical advice 4525 (4.0) 8323 (2.2) 32546 (5.8) 43506 (3.7) Admitted 9544 (8.4) 101667 (26.3) 64298 (11.4) 121653 (10.2) Transferred to another facility 6952 (6.1) 8706 (2.3) 10989 (2.0) 18268 (1.5) Died 41 (0.0) 565 (0.1) 145 (0.0) 388 (0.0) Hospitalization characteristics (DAD metadata) No. of patients with at least 1 admission (%) 6825 (20.0) 45430 (60.6) 21745 (44.2) 72084 (24.6) No. of admissions 8078 100924 57359 110157 Top 5 ICD-10-CA primary diagnosis chapters, n (%) 1 Digestive
1574 (19.5)Circulatory
30001 (29.7)Digestive
12229 (21.3)Digestive
19370 (17.6)2 Injury and poisoning
1351 (16.7)Respiratory
20441 (20.3)Abnormal clinical findings
6901 (12.0)Injury and poisoning
14330 (13.0)3 Circulatory
1286 (15.9)Abnormal clinical findings
7836 (7.8)Injury and poisoning
5604 (9.8)Abnormal clinical findings
12961 (11.8)4 Abnormal clinical findings
599 (7.4)Neoplasms and blood
7459 (7.4)Circulatory
4707 (8.2)Circulatory
12934 (11.7)5 Genitourinary
560 (6.9)Digestive
6693 (6.6)Genitourinary
4615 (8.0)Genitourinary
9034 (8.2)All alcohol-related diagnoses, n (%) No 8027 (99.4) 100643 (99.7) 55351 (96.5) 108918 (98.9) Yes 51 (0.6) 281 (0.3) 2008 (3.5) 1239 (1.1) Mental health hospitalization–related characteristics (HMHDB metadata) No. of patients with at least 1 admission (%) 1103 (3.2) 4955 (6.6) 10048 (20.4) 20031 (6.8) No. of mental health–related admissions 1926 8467 40 406 45 035 Diagnosis category among mental health–related admissions, n (%) Mood disorder 629 (32.7) 1967 (23.2) 10473 (25.9) 14071 (31.2) Schizophrenic and psychotic disorder 524 (27.2) 1291 (15.2) 9852 (24.4) 11582 (25.7) Substance-related disorder 337 (17.5) 1150 (13.6) 10686 (26.4) 8766 (19.5) Organic disorder 177 (9.2) 3097 (36.6) 1379 (3.4) 3606 (8.0) Other mental health disorder 137 (7.1) 423 (5.0) 3248 (8.0) 3478 (7.7) Anxiety disorder 57 (3.0) 344 (4.1) 1582 (3.9) 1772 (3.9) Personality disorder 51 (2.6) 162 (1.9) 2964 (7.3) 1517 (3.4) Non–mental health disorder 11 (0.6) 30 (0.4) 177 (0.4) 183 (0.4) Unknown disorder 3 (0.2) 3 (0.0) 45 (0.1) 60 (0.1) Note: CHF = congestive heart failure, COPD = chronic obstructive pulmonary disease, 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, UTI = urinary tract infection.
- Table 5:
Cluster analysis and subgroup characterization among people who made frequent emergency department visits from Apr. 1, 2013, to Mar. 31, 2014 — Alberta
Characteristic Subgroup 1 (“Short duration”) Subgroup 2 (“Older patients”) Subgroup 3 (“Young mental health”) Subgroup 4 (“Injury”) Subgroup characteristics (clustering variables) No. of patients 4301 18776 12827 67722 Age, yr, median (IQR) 44 (31–58) 64 (48–78) 40 (28–55) 40 (27–58) No. of visits to the emergency department, median (IQR) 3 (2–4) 3 (2–5) 7 (4–11) 3 (2–4) Charlson Comorbidity Index, median (IQR) 0 (0–0) 1 (1–1) 0 (0–0) 0 (0–0) No. of different discharge diagnosis chapters, median (IQR) 2 (2–2) 4 (3–5) 5 (5–6) 3 (2–4) No. of months in the year that patients visited the emergency department, median (IQR) 1 (1–1) 4 (3–5) 7 (6–8) 3 (2–4) Regularity index, median (IQR) 1 (0.8–1) 1 × 10−7 (0.7 × 10−7 to 3.8 × 10−5) 1.6 × 10−7 (1.2 × 10−7 to 2.6 × 10−7) 0.9 × 10−7 (0.6 × 10−7 to −8.6 × 10−5) Patient characteristics (NACRS metadata) Gender, n (%) Female 1868 (43.4) 9744 (51.9) 7766 (60.5) 37888 (55.9) Male 17241 (50.5) 35420 (47.2) 20030 (40.7) 126667 (43.3) Other 0 (0.0) 0 (0.0) 0 (0.0) 1 (0.0) Undifferentiated 0 (0.0) 0 (0.0) 1 (0.0) 1 (0.0) Not available 0 (0.0) 0 (0.0) 0 (0.0) 1 (0.0) Rural or urban, n (%) Rural 1428 (33.2) 6720 (35.8) 5526 (43.1) 22378 (33.0) Urban 2850 (66.3) 11921 (63.5) 6846 (53.4) 44610 (65.9) Emergency department visit characteristics (NACRS metadata) No. of emergency department visits 499395 1587307 139770 780967 Top 5 ICD-10 emergency department primary diagnoses, n (%) 1 Drug therapies
12356 (48.0)Drug therapies
9492 (7.0)Drug therapies
31466 (15.3)Drug therapies
38202 (9.9)2 Dressings
1574 (6.1)COPD
4599 (3.4)Dressings
6016 (2.9)Dressings
12771 (3.3)3 Other medical care
823 (3.2)Bronchitis
4241 (3.1)Abdominal pain
5650 (2.7)UTI
9159 (2.4)4 Cellulitis of lower limb
623 (2.4)CHF
3919 (2.9)UTI
4044 (2.0)Abdominal pain
9075 (2.4)5 Periapical abscess
372 (1.4)Asthma
3025 (2.2)Alcohol intoxication
4329 (2.1)Orthopedic care
8380 (2.2)Visit disposition, n (%) Discharged 23892 (92.9) 102510 (76.0) 177626 (86.3) 334800 (87.0) Left against medical advice 409 (1.6) 3306 (2.5) 10731 (5.2) 14663 (3.8) Admitted 762 (3.0) 24873 (18.4) 14082 (6.8) 27476 (7.1) Transferred to another facility 654 (2.5) 4090 (3.0) 3376 (1.6) 7861 (2.0) Died 2 (0.0) 119 (0.1) 37 (0.0) 53 (0.0) Hospitalization characteristics (DAD metadata) No. of patients with at least 1 admission (%) 603 (14.0) 10926 (58.2) 6209 (48.4) 18857 (27.8) No. of admissions 728 26281 15937 29826 Top 5 ICD-10-CA primary diagnosis chapters, n (%) 1 Digestive
125 (17.2)Circulatory
6145 (23.4)Mental and behavioural
3522 (22.1)Digestive
4581 (15.4)2 Injury and poisoning
120 (16.5)Respiratory
5693 (21.7)Digestive
2933 (18.4)Injury and poisoning
4404 (14.8)3 Genitourinary
73 (10)Abnormal clinical findings
2175 (8.3)Injury and poisoning
1655 (10.4)Mental and behavioural
3526 (11.8)4 Pregnancy
71 (9.8)Digestive
2033 (7.7)Abnormal clinical findings
1347 (8.5)Abnormal clinical findings
2647 (8.9)5 Circulatory
57 (7.8)Endocrine
1558 (5.9)Respiratory
906 (5.7)Genitourinary
2405 (8.1)All alcohol-related diagnoses, n (%) No 726 (99.7) 26117 (99.4) 14479 (90.9) 28939 (97.0) Yes 2 (0.3) 164 (0.6) 1458 (9.1) 887 (3.0) Mental health hospitalization–related characteristics (HMHDB metadata) No. of patients with at least 1 admission (%) 58 (1.3) 1399 (7.5) 2842 (22.2) 4522 (6.7) No. of mental health–related admissions 85 2400 10 065 9439 Diagnosis category among mental health–related admissions, n (%) Mood disorder 18 (21.2) 433 (18) 1629 (16.2) 2137 (22.6) Schizophrenic and psychotic disorder 19 (22.4) 288 (12) 1350 (13.4) 1555 (16.5) Substance-related disorder 20 (23.5) 536 (22.3) 4583 (45.5) 3236 (34.3) Organic disorder 9 (10.6) 739 (30.8) 252 (2.5) 587 (6.2) Other mental health disorder 12 (14.1) 210 (8.8) 1110 (11.0) 1144 (12.1) Anxiety disorder 4 (4.7) 146 (6.1) 407 (4.0) 421 (4.5) Personality disorder 1 (1.2) 43 (1.8) 708 (7.0) 322 (3.4) Non–mental health disorder 2 (2.4) 5 (0.2) 26 (0.3) 37 (0.4) Note: CHF = congestive heart failure, COPD = chronic obstructive pulmonary disease, 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, UTI = urinary tract infection.