Grant: Project Grant

Canadians rely extensively on the Emergency Department (ED), we are among the highest ED use group globally. Beyond this, there are some individuals who use the ED more frequently than others. Frequent users (having at least 3 visits to the ED in a year) are a complex group of patients who often have healthcare needs that are not optimally managed in the ED. There are many factors that have been associated previously with frequent use (such as mental illness, homelessness, and substance use); however there are also many unknowns about this group of patients. The objectives of this research are 3 fold: 1) To characterize and describe the different distinct groups of frequent users 2) To host an expert panel to hypothesize mechanisms that drive frequent use and develop consensus on which groups would be priority for further exploration and understanding 3) To understand why individuals are using the ED frequently Objective 1 will be completed using administrative healthcare data from across the province of Alberta (2022 - 2025). Individuals who are frequent users of the ED (at least 3 visits in 12 months) will be identified. Machine learning methods will be used to cluster patients with similar usage patterns and clinical and demographic characteristics together so distinct groups can be defined. In Objective 2 a group of experts in the care of these complex patients will be convened. These experts will be presented with the groups identified in Objective 1 and asked to hypothesize mechanisms that may be driving frequent use and identify 3 priority groups for intervention. In Objective 3 we will work with the priority groups identified in Objective 2. We will interview patients who have similar characteristics to the priority frequent user group to understand their needs, priorities, and reasons for ED use.