Evidence map›Paper›PMID 35292480›Full record

ArticleCMAJ open

People who make frequent emergency department visits based on persistence of frequent use in Ontario and Alberta: a retrospective cohort study.

Jessica Moe, Elle Yuequiao Wang, Margaret J McGregor, Michael J Schull, Kathryn Dong, Brian R Holroyd, Corinne M Hohl, Eric Grafstein, Fiona O'Sullivan, Johanna Trimble and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Profiles of Emergency Department Users with Psychiatric Disorders Related to Barriers to Outpatient Care.International journal of environmental research and public health · 2024
    Article
  8. Article
  9. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Jessica MoeDepartment of Emergency Medicine (Moe, Wang, Hohl, O'Sullivan), University of British Columbia; Department of Emergency Medicine (Moe, Hohl), Vancouver General Hospital; Department of Family Practice (McGregor), Department of Emergency Medicine (Grafstein), University of British Columbia, Vancouver, BC; ICES Central (Schull); Department of Medicine (Schull), University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Dong, Holroyd), University of Alberta; Emergency Strategic Clinical Network (Holroyd), Alberta Health Services, Edmonton, Alta.; Vancouver Coastal Health (Grafstein), Vancouver, BC; Providence Health Care (Grafstein), Vancouver, BC; Patients for Patient Safety Canada (Trimble), Ottawa, Ont.; School of Population and Public Health and Centre for Health Services and Policy Research (McGrail), University of British Columbia, Vancouver, BC jessica.moe@ubc.ca.
Elle Yuequiao WangDepartment of Emergency Medicine (Moe, Wang, Hohl, O'Sullivan), University of British Columbia; Department of Emergency Medicine (Moe, Hohl), Vancouver General Hospital; Department of Family Practice (McGregor), Department of Emergency Medicine (Grafstein), University of British Columbia, Vancouver, BC; ICES Central (Schull); Department of Medicine (Schull), University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Dong, Holroyd), University of Alberta; Emergency Strategic Clinical Network (Holroyd), Alberta Health Services, Edmonton, Alta.; Vancouver Coastal Health (Grafstein), Vancouver, BC; Providence Health Care (Grafstein), Vancouver, BC; Patients for Patient Safety Canada (Trimble), Ottawa, Ont.; School of Population and Public Health and Centre for Health Services and Policy Research (McGrail), University of British Columbia, Vancouver, BC.
Margaret J McGregorDepartment of Emergency Medicine (Moe, Wang, Hohl, O'Sullivan), University of British Columbia; Department of Emergency Medicine (Moe, Hohl), Vancouver General Hospital; Department of Family Practice (McGregor), Department of Emergency Medicine (Grafstein), University of British Columbia, Vancouver, BC; ICES Central (Schull); Department of Medicine (Schull), University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Dong, Holroyd), University of Alberta; Emergency Strategic Clinical Network (Holroyd), Alberta Health Services, Edmonton, Alta.; Vancouver Coastal Health (Grafstein), Vancouver, BC; Providence Health Care (Grafstein), Vancouver, BC; Patients for Patient Safety Canada (Trimble), Ottawa, Ont.; School of Population and Public Health and Centre for Health Services and Policy Research (McGrail), University of British Columbia, Vancouver, BC.
Michael J SchullDepartment of Emergency Medicine (Moe, Wang, Hohl, O'Sullivan), University of British Columbia; Department of Emergency Medicine (Moe, Hohl), Vancouver General Hospital; Department of Family Practice (McGregor), Department of Emergency Medicine (Grafstein), University of British Columbia, Vancouver, BC; ICES Central (Schull); Department of Medicine (Schull), University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Dong, Holroyd), University of Alberta; Emergency Strategic Clinical Network (Holroyd), Alberta Health Services, Edmonton, Alta.; Vancouver Coastal Health (Grafstein), Vancouver, BC; Providence Health Care (Grafstein), Vancouver, BC; Patients for Patient Safety Canada (Trimble), Ottawa, Ont.; School of Population and Public Health and Centre for Health Services and Policy Research (McGrail), University of British Columbia, Vancouver, BC.
Kathryn DongDepartment of Emergency Medicine (Moe, Wang, Hohl, O'Sullivan), University of British Columbia; Department of Emergency Medicine (Moe, Hohl), Vancouver General Hospital; Department of Family Practice (McGregor), Department of Emergency Medicine (Grafstein), University of British Columbia, Vancouver, BC; ICES Central (Schull); Department of Medicine (Schull), University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Dong, Holroyd), University of Alberta; Emergency Strategic Clinical Network (Holroyd), Alberta Health Services, Edmonton, Alta.; Vancouver Coastal Health (Grafstein), Vancouver, BC; Providence Health Care (Grafstein), Vancouver, BC; Patients for Patient Safety Canada (Trimble), Ottawa, Ont.; School of Population and Public Health and Centre for Health Services and Policy Research (McGrail), University of British Columbia, Vancouver, BC.
Brian R HolroydDepartment of Emergency Medicine (Moe, Wang, Hohl, O'Sullivan), University of British Columbia; Department of Emergency Medicine (Moe, Hohl), Vancouver General Hospital; Department of Family Practice (McGregor), Department of Emergency Medicine (Grafstein), University of British Columbia, Vancouver, BC; ICES Central (Schull); Department of Medicine (Schull), University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Dong, Holroyd), University of Alberta; Emergency Strategic Clinical Network (Holroyd), Alberta Health Services, Edmonton, Alta.; Vancouver Coastal Health (Grafstein), Vancouver, BC; Providence Health Care (Grafstein), Vancouver, BC; Patients for Patient Safety Canada (Trimble), Ottawa, Ont.; School of Population and Public Health and Centre for Health Services and Policy Research (McGrail), University of British Columbia, Vancouver, BC.
Corinne M HohlDepartment of Emergency Medicine (Moe, Wang, Hohl, O'Sullivan), University of British Columbia; Department of Emergency Medicine (Moe, Hohl), Vancouver General Hospital; Department of Family Practice (McGregor), Department of Emergency Medicine (Grafstein), University of British Columbia, Vancouver, BC; ICES Central (Schull); Department of Medicine (Schull), University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Dong, Holroyd), University of Alberta; Emergency Strategic Clinical Network (Holroyd), Alberta Health Services, Edmonton, Alta.; Vancouver Coastal Health (Grafstein), Vancouver, BC; Providence Health Care (Grafstein), Vancouver, BC; Patients for Patient Safety Canada (Trimble), Ottawa, Ont.; School of Population and Public Health and Centre for Health Services and Policy Research (McGrail), University of British Columbia, Vancouver, BC.
Eric GrafsteinDepartment of Emergency Medicine (Moe, Wang, Hohl, O'Sullivan), University of British Columbia; Department of Emergency Medicine (Moe, Hohl), Vancouver General Hospital; Department of Family Practice (McGregor), Department of Emergency Medicine (Grafstein), University of British Columbia, Vancouver, BC; ICES Central (Schull); Department of Medicine (Schull), University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Dong, Holroyd), University of Alberta; Emergency Strategic Clinical Network (Holroyd), Alberta Health Services, Edmonton, Alta.; Vancouver Coastal Health (Grafstein), Vancouver, BC; Providence Health Care (Grafstein), Vancouver, BC; Patients for Patient Safety Canada (Trimble), Ottawa, Ont.; School of Population and Public Health and Centre for Health Services and Policy Research (McGrail), University of British Columbia, Vancouver, BC.
Fiona O'SullivanDepartment of Emergency Medicine (Moe, Wang, Hohl, O'Sullivan), University of British Columbia; Department of Emergency Medicine (Moe, Hohl), Vancouver General Hospital; Department of Family Practice (McGregor), Department of Emergency Medicine (Grafstein), University of British Columbia, Vancouver, BC; ICES Central (Schull); Department of Medicine (Schull), University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Dong, Holroyd), University of Alberta; Emergency Strategic Clinical Network (Holroyd), Alberta Health Services, Edmonton, Alta.; Vancouver Coastal Health (Grafstein), Vancouver, BC; Providence Health Care (Grafstein), Vancouver, BC; Patients for Patient Safety Canada (Trimble), Ottawa, Ont.; School of Population and Public Health and Centre for Health Services and Policy Research (McGrail), University of British Columbia, Vancouver, BC.
Johanna TrimbleDepartment of Emergency Medicine (Moe, Wang, Hohl, O'Sullivan), University of British Columbia; Department of Emergency Medicine (Moe, Hohl), Vancouver General Hospital; Department of Family Practice (McGregor), Department of Emergency Medicine (Grafstein), University of British Columbia, Vancouver, BC; ICES Central (Schull); Department of Medicine (Schull), University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Dong, Holroyd), University of Alberta; Emergency Strategic Clinical Network (Holroyd), Alberta Health Services, Edmonton, Alta.; Vancouver Coastal Health (Grafstein), Vancouver, BC; Providence Health Care (Grafstein), Vancouver, BC; Patients for Patient Safety Canada (Trimble), Ottawa, Ont.; School of Population and Public Health and Centre for Health Services and Policy Research (McGrail), University of British Columbia, Vancouver, BC.
Kimberlyn M McGrailDepartment of Emergency Medicine (Moe, Wang, Hohl, O'Sullivan), University of British Columbia; Department of Emergency Medicine (Moe, Hohl), Vancouver General Hospital; Department of Family Practice (McGregor), Department of Emergency Medicine (Grafstein), University of British Columbia, Vancouver, BC; ICES Central (Schull); Department of Medicine (Schull), University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Dong, Holroyd), University of Alberta; Emergency Strategic Clinical Network (Holroyd), Alberta Health Services, Edmonton, Alta.; Vancouver Coastal Health (Grafstein), Vancouver, BC; Providence Health Care (Grafstein), Vancouver, BC; Patients for Patient Safety Canada (Trimble), Ottawa, Ont.; School of Population and Public Health and Centre for Health Services and Policy Research (McGrail), University of British Columbia, Vancouver, BC.

Funding

CIHR
6 · The paper itself

Abstract

backgroundThe factors that underlie persistent frequent visits to the emergency department are poorly understood. This study aimed to characterize people who visit emergency departments frequently in Ontario and Alberta, by number of years of frequent use.

methodsThis was a retrospective cohort study aimed at capturing information about patients visiting emergency departments in Ontario and Alberta, Canada, from Apr. 1, 2011, to Mar. 31, 2016. We identified people 18 years or older with frequent emergency department use (top 10% of emergency department use) in fiscal year 2015/16, using the Dynamic Cohort from the Canadian Institute of Health Information. We then organized them into subgroups based on the number of years (1 to 5) in which they met the threshold for frequent use over the study period. We characterized subgroups using linked emergency department, hospitalization and mental health-related hospitalization data.

resultsWe identified 252 737 people in Ontario and 63 238 people in Alberta who made frequent visits to the emergency department. In Ontario and Alberta, 44.3% and 44.7%, respectively, met the threshold for frequent use in only 1 year and made 37.9% and 38.5% of visits; 6.8% and 8.2% met the threshold for frequent use over 5 years and made 11.9% and 13.2% of visits. Many characteristics followed gradients based on persistence of frequent use: as years of frequent visits increased (1 to 5 years), people had more comorbidities, homelessness, rural residence, annual emergency department visits, alcohol- and substance use-related presentations, mental health hospitalizations and instances of leaving hospital against medical advice.

interpretationHigher levels of comorbidities, mental health issues, substance use and rural residence were seen with increasing years of frequent emergency department use. Interventions upstream and in the emergency department must address unmet needs, including services for substance use and social supports.

Indexed as

Emergency Service, HospitalSubstance-Related DisordersAlbertaCohort StudiesHumansOntarioRetrospective Studies

Identifiers

PMID35292480
PMCPMC8929439

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.