Common characteristics of high intensity A&E attendances
Telstra Health's Dr Foster recently carried out a detailed analysis of accident and emergency (A&E) attendances in England with the aim of uncovering common characteristics of high intensity users (HIUs) - people who attended 10 or more times in a 12-month period - and patterns in HIU attendances to provide valuable insight and a better understanding of the reasons they attend with such high frequency.
The analysis examined data from A&E departments across England demonstrating that a small cohort of people are receiving a significant allocation of NHS resources compared to the average population:
- 31,492 people made more than half a million visits to A&E, this is equivalent to 4 per cent of all A&E attendances.
- Ten patients visited A&E over 235 times each, with some attending, on average, in excess of once a day.
- This is increasing the pressure on the NHS and contributing to the rising cost of healthcare.
With A&E attendances at an all-time high, reducing people’s reliance on urgent and emergency care has been an area of focus for the NHS in recent years. In looking to reduce the burden of this small cohort of patients, it is important to understand why these patients are visiting A&E so frequently. Such high attendance suggests that their needs are not being addressed elsewhere in the system and they may be better served with specialist care.
Numerous initiatives have been launched to encourage the public to consider whether they really need to visit A&E. However, successful initiatives specifically targeting HIUs, suggest that this group of patients may require a more personalised approach. One such initiative saw Dr Foster and the team at Aintree University Hospital analyse data on high intensity users. An overview of this case study is provided in the report download (below).
The most common reasons for re-attendance were persistent pain and, in particular, clinical presentations that frequently involved presentation of medically unexplained symptoms (MUS). Analyses of this kind will play an important role in reducing HIU attendances. Localised data will help NHS hospitals understand why HIUs are attending regularly, and how they can be aided to better manage their health at home, or use primary healthcare.