Psychiatric Characteristics of Frequent Attenders at Accident and Emergency: A Case Register Comparison with Non Frequent Attenders

Background and aims: Patients attending Accident and Emergency (A&E) on a frequent basis consume a large amount of NHS resources and often frustrate health workers employed in the service. This audit aimed to identify the personal and psychiatric characteristics of these patients and highlight areas where intervention may be helpful. Method and results: Patients presenting to A&E more than 20 times in four years were comparison to non-frequent attenders using case register information. The study demonstrates that frequent attenders are well known to psychiatric services, but are not engaged in ongoing contact. This is not due to a difference in attendance rate between frequent attenders and controls but may represent reluctance for follow up either on the part of the patient or the psychiatrist. Conclusions: These patients have a combination of physical, psychiatric and social pathologies and the services to address these needs does not seem to currently exist but should be considered.