Healthcare Seeking Behavior of Frequent Emergency Care Visitors

NCT05953467 | Recruiting

• 1 other identifier: METC Z20230010
• Study Type: observational
• Target: 700
• Locations: 1 country
• Sites: 1

Brief Summary

This retrospective study is part of a research line from Zuyderland Medical Centre focusing on the acute care chain. The aim of the study is to focus on the frequent visitors of the Emergency Department (ED) and bridge the gap to out-of-hours primary care. Although the Dutch healthcare system is unique with their 24/7 accessibility to primary care, crowding within the acute care chain is a growing problem, even in the Netherlands. Patients visiting an ED multiple times a year, the so called frequent visitors are one of the contributing factors of ED crowding. This relatively small group of patients accounts for a disproportionate number of many ED visits. In the United States, it is estimated that between 4.5 and 8% of patients are responsible for almost one third of the total annual number of ED visits, by visiting the ED four or more times per year. Dutch research by vd Linden found that 0.5% of total ED patients visited their ED frequently, however, they defined frequent visitors using a threshold of 7 visits per year. In our study, the cutoff of more than four visits per year to define a frequent visitor is used. This study aims to gain insight in who Dutch frequent visitors are, or - in other words - what their baseline characteristics are, which complaints are responsible for their healthcare seeking behavior, and do these patients also seek medical help at other places during out-of-hours like a General Practitioner Cooperative (GPC)? Existing ED and GCP data will be used to identify patients who either visited the ED or one of the adjacent GPCs 4 times or more in one year. Using these data, this study aims to answer the following questions: Primary objective: \- How many patients present to the ED of the Zuyderland hospital in Heerlen and Sittard 4 times or more a year and what are the characteristics of these frequent visitors of the ED? Secondary objective:

• How many patients present to the GPC of South East Limburg 4 or more times a year and what are their characteristics of frequent visitor?
• Is there an association between the characteristics of frequent visitors of the ED of the Zuyderland hospital and subsequent (frequent) presentation at the GPC?

Conditions

Emergency Care; Acute Care Chain

Outcome Measures

Primary Outcomes (1)

• How many patients present to the ED of the Zuyderland hospital in Heerlen and Sittard 4 times or more a year and what are the characteristics of these frequent visitors of the ED?

  Frequency count: Measure the exact number of ED visits for each patient over the specified time frame. Frequency count on the number of males and females. Frequency count on presenting complaints.

  1 year

Secondary Outcomes (4)

• How many patients present to the GPC of South East Limburg 4 times or more a year and what are their characteristics of frequent visitor?

  1 year

• Do frequent visitors of the ED visit the GPC frequently as well?

  1 year

• Do frequent visitors of the GPC visit the ED frequently as well?

  1 year

• Do frequent visitors of the ED and the GPC visit those for the same reason?

  1 year

Interventions

No intervention, observational. OTHER

None, observational study

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All patients presenting at the ED or GPC of Zuyderland Medical Center between 1 January 2022 and 31 December 2022, with an age of 18 years or older at time of first presentation during the inclusion period, will be included. Frequent visitors, defined as patients visiting the ED or GPC 4 times or more during these 12 months, will be identified and characterized. The geography of south east Limburg and the locations of EDs with integrated GPC, ensure that visitors in general visit the same location.

You may qualify if:

• All adult patients aged 18 years or older at first ED presentation in 2022 who visited the ED 4 times or more in 2022.
• All adult patients aged 18 years or older at first GPC presentation in 2022 who visited the GPC 4 times or more.

Sponsors & Collaborators

• Zuyderland Medisch Centrum: lead

Study Sites (1)

Zuyderland MC

Heerlen, Limburg, 6226WS, Netherlands

RECRUITING

Central Study Contacts

Lieke Claassen

CONTACT

0031884592802; l.claassen@zuyderland.nl

Gideon Latten

CONTACT

0031884592802; g.latten@zuyderland.nl

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 12, 2023
• First Posted: July 20, 2023
• Study Start: July 11, 2023
• Primary Completion: December 31, 2024
• Study Completion: December 31, 2024
• Last Updated: February 29, 2024

Record last verified: 2024-02

Data Sharing

• IPD Sharing: Will not share

Locations

NL (1)