American Research Journal of Nursing

Emergency department (ED) services are expensive and often overused by the surrounding community, resulting in overcrowding and strain on healthcare services. ED overuse has been identified as major source of healthcare expenditure and can be as high as 3 times the costs from other healthcare settings To have an effective impact on admissions by ED frequent users, each hospital needs to understand its unique profile and the characteristics of patients who overuse ED services. Only then can an effective program be developed to alleviate their patients’ dependency on the ED for care. The purpose of this study was to develop a patient profile of ED frequent users at a mid-sized hopsital in the Midwest. This research used a descriptive retrospective design to review electronic medical health records of patients with 6 or more visits to the ED within a year. Data were collected for the following demographic information: gender, age, race/ethnicity, primary language, marital status, employment status, zip code, total visits per 12-month time period, time of visit to ED, presenting complaint, length of time in ED, admission to hospital, primary ECD 9 diagnosis, discharge disposition from ED, primary insurance, primary care provider, and reported health status. The research findings supports that older adults, especially females, with chronic illnesses such as CHF, diabetes, and respiratory illnesses are at high risk for becoming frequent users of ED services. The outcomes of this study are being used to develop a transitional care model program specifically designed for elderly patient with co-morbidities. The program will use a collaborative approach between ED physicians and nurses with nurse practitioner students to see patients not only in the ED but for 60 days following discharge. An overarching expected benefit will be to reduce overall ED costs while increasing patient satisfaction for frequent ED users. Developing programs to assist frequent ED users is imperative to assist elderly patients in coping with their chronic conditions without the reliance of ED services.