High frequency emergency department use and heterogeneity of reasons for attendance by children and young people: a retrospective cohort study

Authors

• Akshay Kumar, University of Sheffield
• Rebecca M Simpson, UoP RU - Participation in Everyday Life Research Group
• Kerryn Husk, Peninsula Medical School
• Graham D Johnson, University Hospitals of Derby and Burton NHS Foundation Trust
• Chris Burton, University of Sheffield

ORCID

• Rebecca M Simpson: 0009-0006-9330-9382
• Kerryn Husk: 0000-0001-5674-8673

Abstract

Objective To quantify patterns of emergency department (ED) use over two consecutive 12-month periods among children aged 15 and under, and to assess heterogeneity of reasons for attendance in high-frequency users.Design Population-based retrospective cohort study of routinely collected ED data.Setting EDs in the Yorkshire and Humber region, UK, from 31 March 2014 to 1 April 2017.Patients Children aged 15 and under with ≥1 ED attendance.Main outcome measures Proportion with ≥7 attendances over 2 years and heterogeneity of diagnostic reasons quantified by the Herfindahl index.Results The cohort included 71 143 individuals. Although only 13.6% were high-frequency attenders in the first year, over half (55.1%) of these made at least one attendance in the second year. A subset (14.1%) remained high-frequency attenders across both years and were more likely to belong to the most deprived deprivation category. Children aged 8–12 were more likely to attend for injury-related issues and showed lower heterogeneity in reasons for attendance, while infants under age 1 had more illness-related attendances and greater heterogeneity.Conclusions A notable proportion of children and young people frequently attend EDs over a 2-year period. This study introduces a method for quantifying heterogeneity in reasons for attendance, which may support future predictive modelling using electronic health records to identify and support high-frequency ED users.

DOI Link

10.1136/bmjpo-2025-003907

Publication Date

2026-02-26

Publication Title

BMJ Paediatrics Open

Volume

10

Issue

1

Acceptance Date

2026-01-30

Deposit Date

2026-02-27

Funding

This research was funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration Yorkshire and Humber (funder reference: NIHR200166), at the University of Sheffield and supported by the NIHR Applied Research Collaboration South West Peninsula.

Keywords

Children, Statistics

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Recommended Citation

Kumar, A., Simpson, R., Husk, K., Johnson, G., & Burton, C. (2026) 'High frequency emergency department use and heterogeneity of reasons for attendance by children and young people: a retrospective cohort study', BMJ Paediatrics Open, 10(1). Available at: 10.1136/bmjpo-2025-003907