Demographic and health care utilization characteristics of people who made frequent visits to the emergency department in Ontario
| Characteristic | Apr. 1, 2011–Mar. 31, 2012 | Apr. 1, 2012–Mar. 31, 2013 | Apr. 1, 2013–Mar. 31, 2014 | Apr. 1, 2014–Mar. 31, 2015 | Apr. 1, 2015–Mar. 31, 2016 |
|---|---|---|---|---|---|
| Emergency department visit characteristics (NACRS metadata) | |||||
| No. of patients | 435334 | 446954 | 451568 | 465949 | 477647 |
| No. of visits per patient, median (IQR) | 4 (3–5) | 4 (3–5) | 4 (3–5) | 4 (3–5) | 4 (3–5) |
| No. of emergency department visits | 2004975 | 2053609 | 2079281 | 2149965 | 2213161 |
| Arrival by ambulance, n (%) | |||||
| Air ambulance | 486 (0) | 422 (0) | 369 (0) | 459 (0) | 411 (0) |
| Air and ground ambulance | 978 (0) | 1119 (0.1) | 1054 (0.1) | 1283 (0.1) | 1315 (0.1) |
| Ground ambulance | 352171 (17.6) | 376214 (18.3) | 397811 (19.1) | 428368 (19.9) | 446762 (20.2) |
| No ambulance | 1651340 (82.4) | 1675854 (81.6) | 1680047 (80.8) | 1719855 (80.0) | 1764673 (79.7) |
| Triage level (CTAS), n (%) | |||||
| 1 (resuscitation) | 13123 (0.7) | 14229 (0.7) | 16599 (0.8) | 18759 (0.9) | 20796 (0.9) |
| 2 (emergent) | 332219 (16.6) | 361122 (17.6) | 402949 (19.4) | 435122 (20.2) | 458014 (20.7) |
| 3 (urgent) | 849844 (42.4) | 896673 (43.7) | 931616 (44.8) | 975875 (45.4) | 1012638 (45.8) |
| 4 (less urgent) | 648833 (32.4) | 634937 (30.9) | 597374 (28.7) | 588964 (27.4) | 593436 (26.8) |
| 5 (nonurgent) | 151140 (7.5) | 137432 (6.7) | 121391 (5.8) | 114988 (5.3) | 113565 (5.1) |
| Unknown | 8040 (0.4) | 7607 (0.4) | 7615 (0.4) | 14344 (0.7) | 12344 (0.6) |
| Not available | 1776 (0.1) | 1609 (0.1) | 1737 (0.1) | 1913 (0.1) | 2368 (0.1) |
| Top 5 ICD-10-CA primary diagnosis chapters, n (%) | |||||
| 1 | Respiratory 162000 (8.1) | Respiratory 170897 (8.3) | Respiratory 160762 (7.7) | Respiratory 180688 (8.4) | Respiratory 178433 (8.1) |
| 2 | Musculoskeletal 136297 (6.8) | Musculoskeletal 137722 (6.7) | Musculoskeletal 140076 (6.7) | Musculoskeletal 146490 (6.8) | Musculoskeletal 154688 (7.0) |
| 3 | Abnormal clinical findings 412 928 (20.6) | Abnormal clinical findings 427536 (20.8) | Abnormal clinical findings 442744 (21.3) | Abnormal clinical findings 458415 (21.3) | Abnormal clinical findings 473430 (21.4) |
| 4 | Injury and poisoning 285123 (14.2) | Injury and poisoning 294076 (14.3) | Injury and poisoning 300560 (14.5) | Injury and poisoning 305651 (14.2) | Injury and poisoning 320186 (14.5) |
| 5 | General health status 215204 (10.7) | General health status 212930 (10.4) | General health status 210348 (10.1) | General health status 205890 (9.6) | General health status 202791 (9.2) |
| Visit disposition, n (%) | |||||
| Discharged | 1620491 (80.8) | 1658247 (80.7) | 1679353 (80.8) | 1732802 (80.6) | 1778194 (80.4) |
| Transferred or admitted | 290321 (14.5) | 306710 (14.8) | 315618 (15.2) | 326049 (15.2) | 337594 (15.2) |
| Left against medical advice | 93003 (4.6) | 87501 (4.3) | 83169 (4) | 89909 (4.2) | 96255 (4.3) |
| Died | 1160 (0.1) | 1151 (0.1) | 1141 (0.1) | 1205 (0.1) | 1118 (0) |
| Hospitalization characteristics (DAD metadata) | |||||
| No. of admissions | 255202 | 268573 | 276307 | 284787 | 292411 |
| No. of admissions per patient, median (IQR) | 1 (1–2) | 1 (1–2) | 1 (1–2) | 1 (1–2) | 1 (1–2) |
| Top 5 ICD-10 primary diagnosis chapters simplified, n (%) | |||||
| 1 | Circulatory 45573 (17.9) | Circulatory 46974 (17.5) | Circulatory 48260 (17.5) | Circulatory 49267 (17.3) | Circulatory 50029 (17.1) |
| 2 | Respiratory 9491 (11.6) | Respiratory 32452 (12.1) | Respiratory 32177 (11.6) | Respiratory 36479 (12.8) | Respiratory 35749 (12.2) |
| 3 | Digestive 36263 (14.2) | Digestive 37876 (14.1) | Digestive 39235 (14.2) | Digestive 38983 (13.7) | Digestive 41150 (14.1) |
| 4 | Abnormal clinical findings 26679 (10.5) | Abnormal clinical findings 27441 (10.2) | Abnormal clinical findings 27767 (10.0) | Abnormal clinical findings 27771 (9.8) | Abnormal clinical findings 27636 (9.5) |
| 5 | Injury and poisoning 24054 (9.4) | Injury and poisoning 25134 (9.4) | Injury and poisoning 26302 (9.5) | Injury and poisoning 26175 (9.2) | Injury and poisoning 27506 (9.4) |
| Mental health hospitalization–related characteristics (HMHDB metadata) | |||||
| No. of mental health–related admissions | 37100 | 38282 | 39030 | 39913 | 42708 |
| No. of mental health–related admissions per patient, median (IQR) | 1 (1–2) | 1 (1–2) | 1 (1–2) | 1 (1–2) | 1 (1–2) |
| Diagnosis category, n (%) | |||||
| Mood disorder | 11513 (31.0) | 11563 (30.2) | 11148 (28.6) | 11565 (29.0) | 12038 (28.2) |
| Schizophrenic and psychotic disorder | 9355 (25.2) | 9362 (24.5) | 9797 (25.1) | 9008 (22.6) | 9192 (21.5) |
| Substance-related disorder | 7097 (19.1) | 7200 (18.8) | 7484 (19.2) | 7849 (19.7) | 8758 (20.5) |
| Organic disorder | 3628 (9.8) | 4275 (11.2) | 4615 (11.8) | 4974 (12.5) | 5721 (13.4) |
| Other mental health disorder | 2679 (7.2) | 2863 (7.5) | 2898 (7.4) | 2988 (7.5) | 3187 (7.5) |
| Anxiety disorder | 1412 (3.8) | 1480 (3.9) | 1467 (3.8) | 1647 (4.1) | 1661 (3.9) |
| Personality disorder | 1245 (3.4) | 1353 (3.5) | 1388 (3.6) | 1672 (4.2) | 1918 (4.5) |
| Non–mental health disorder | 125 (0.3) | 133 (0.3) | 175 (0.4) | 175 (0.4) | 183 (0.4) |
| Unknown disorder (not available) | 46 (0.1) | 53 (0.1) | 58 (0.1) | 35 (0.1) | 50 (0.1) |
Note: CTAS = Canadian Triage and Acuity Scale, DAD = Discharge Abstract Database, HMHDB = Hospital Mental Health Database, ICD-10-CA = International Statistical Classification of Diseases and Related Health Problems, 10th revision, Canadian version, IQR = interquartile range, NACRS = National Ambulatory Care Reporting System.