Characteristics of children who are frequent users of emergency departments in England

Increasing pressures on emergency departments present a considerable challenge worldwide, particularly during winter. Before the COVID-19 pandemic, serious infectious disease incidence had fallen with the success of vaccination programmes. However, amidst the ongoing global pandemic pressure on hospital EDs are stretched to their limit. This can strain health resources and budgets and can result in poor clinical outcomes. Increasing demand for EDs may be driven by rising morbidity in an ageing population, poor access to primary care and increase in patient expectations. In England, in 2017/2018, there were 23.8 million  emergency department attendances, an increase of 22% since 2008/2009; rises were higher in the under-5 (28%–30%), and one-third of all British children visit an  emergency department each year. Such increases pose immense challenges to the National Health Service (NHS) amidst significant cuts in funding, given that that nearly half of the health budget is spent on emergency and acute care.

We conducted an observational study using routine administrative data. Hospital Episode Statistics (HES) data covering all attendances at NHS hospitals in England for the period April 2014–March 2017 were used. We published our study in the Emergency Medicine Journal We found that one in 11 children (9.1%) who attended an  emergency department attended four times or more in a year. Infants, boys and children living in more deprived areas had greater likelihood of being a frequent attender. We concluded that infants and children living in deprived areas have greater likelihood of being frequent attenders. Interventions that support parents and contribute to reducing avoidable emergency department attendance, particularly among infants, are crucial to provide appropriate support to users of emergency departments.