Objective:

To explore drivers of high frequency emergency department (ED) use by children and young people, particularly among those attending EDs most often.

Approach:

• Study Design: A population-based retrospective cohort study using routinely collected linked healthcare data.
• Setting: EDs in the Yorkshire and Humber region of the UK.
• Participants: 288,545 children and young people aged 17 and under making at least one ED attendance in the year period from 1 April 2016 to 31 March 2017.

Key Findings:

• 27,560 (9.6%) of children and young people were defined as high frequency ED attenders, making 3 or more attendances in the year, and accounted for 105,063 (25%) of ED attendances.
• Younger age groups and greater levels of deprivation were associated with higher rates of ED attendance, particularly among those attending the ED most often.
• Ethnicity influenced ED attendance rates, with mixed and other ethnicities showing higher attendance than white, while black ethnicity showed lower attendance compared to white.

Interpretation:

The study highlights the need for multifaceted approaches to reduce frequent ED attendance, considering age, condition specifics, and social determinants of health.

Limitations:

• The study did not involve direct patient and public involvement in its planning or execution.
• Findings may not be generalizable beyond the Yorkshire and Humber region.

Conclusion:

Approaches to reduce frequent ED attendance should be nuanced and consider socioeconomic factors.