• Marcus Eng Hock Ong, Susan Yap, Mariko Siyue Koh, Win Wah, Shu Fen Lim, Yogeswary Pasupathi, Keng Leong Tan, and Cass Jwee Cheong Chay.
• Department of Emergency Medicine, Singapore General Hospital, Singapore.
• Am J Emerg Med. 2014 Aug 1;32(8):895-9.

BackgroundAsthma has been reported as one of the main causes of frequent attendance to the emergency department (ED), and many of those visits are potentially preventable. Understanding the characteristics of frequent attender (FA) patients with asthmatic exacerbations will help to identify factors associated with frequent attendance and improve case management. The aim of this study is to describe the characteristics of FA who present multiple times to the ED for asthma exacerbations.MethodsThis study was a retrospective review of cases presented to Singapore General Hospital ED in 2010. Patients who attended the ED for 4 times or more with at least 1 visit attributable to asthma exacerbations in 2010 were included. They were then categorized as FA with multiple exacerbations (FAME) and those with fewer exacerbations.ResultsOf 105616 ED patients, 155 patients attending the ED in 2010 were identified as FA with asthma, and 26 (17%) of these patients were classified as FAME, resulting in 213 visits (45% of total visits). Compared with FA with fewer exacerbations group, FAME were more likely to be men (P = .002), unemployed (P < .000), bad debtors (P = .045), substance abusers (P = .022), previously known to medical social workers (P = .002), and were found to spend a longer amount of time in the ED (>6 hours) (P = .03).ConclusionWe found that a small number of FAME patients accumulated a large number of ED visits and spent a significantly longer time in the ED. This group tended to be males with social, financial, and addiction problems.Copyright © 2014 Elsevier Inc. All rights reserved.

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