{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T20:40:53Z","timestamp":1760042453208},"reference-count":8,"publisher":"Hindawi Limited","license":[{"start":{"date-parts":[[2012,1,1]],"date-time":"2012-01-01T00:00:00Z","timestamp":1325376000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Scientific World Journal"],"published-print":{"date-parts":[[2012]]},"abstract":"<jats:p>The purpose of this study was to document the clinical and demographic characteristics of the 20 most frequent users of emergency departments (EDs) in one urban area. We reviewed administrative records from three EDs and two agencies providing services to homeless people in Baltimore City. The top 20 users accounted for 2,079 visits at the three EDs. Their mean age was 48, and median age was 51. Nineteen patients visited at least 2 EDs, 18 were homeless, and 13 had some form of public insurance. The vast majority of visits (86%) were triaged as moderate or high acuity. The five most frequent diagnoses were limb pain (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\"><mml:mrow><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>9<\/mml:mn><\/mml:mrow><\/mml:math>), lack of housing (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\"><mml:mrow><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>6<\/mml:mn><\/mml:mrow><\/mml:math>), alteration of consciousness (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\"><mml:mrow><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>6<\/mml:mn><\/mml:mrow><\/mml:math>), infection with human immunodeficiency virus (HIV) (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\"><mml:mrow><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>5<\/mml:mn><\/mml:mrow><\/mml:math>), and nausea\/vomiting (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\"><mml:mrow><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>5<\/mml:mn><\/mml:mrow><\/mml:math>). Hypertension, HIV infection, diabetes, substance abuse, and alcohol abuse were the most common chronic illnesses. The most frequent ED users were relatively young, accounted for a high number of visits, used multiple EDs, and often received high triage scores. Homelessness was the most common characteristic of this patient group, suggesting a relationship between this social factor and frequent ED use.<\/jats:p>","DOI":"10.1100\/2012\/726568","type":"journal-article","created":{"date-parts":[[2012,4,19]],"date-time":"2012-04-19T18:04:09Z","timestamp":1334858649000},"page":"1-6","source":"Crossref","is-referenced-by-count":15,"title":["Ill, Itinerant, and Insured: The Top 20 Users of Emergency Departments in Baltimore City"],"prefix":"10.1100","volume":"2012","author":[{"given":"Barbara Y.","family":"DiPietro","sequence":"first","affiliation":[{"name":"Department of Public Policy, Health Care for the Homeless, 421 Fallsway, Baltimore, MD 21202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dana","family":"Kindermann","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Georgetown University Hospital\/Washington Hospital Center, 110 Irving Street, NW, Washington, DC 20010, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen M.","family":"Schenkel","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Maryland School of Medicine, 110 South Paca Street, Suite 200, Baltimore, MD 21201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"98","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2009.08.004"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2005.12.030"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2008.059428"},{"issue":"1","key":"4","first-page":"9","volume":"48","year":"2006","journal-title":"Annals of Emergency Medicine"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2010.01.032"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1353\/hpu.0.0192"},{"issue":"5","key":"8","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1215\/03616878-23-5-795","volume":"23","year":"1998","journal-title":"Journal of Health Politics, Policy and Law"},{"issue":"3","key":"9","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1097\/00126334-199911010-00009","volume":"22","year":"1999","journal-title":"Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology"}],"container-title":["The Scientific World Journal"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/tswj\/2012\/726568.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/tswj\/2012\/726568.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/tswj\/2012\/726568.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,6,20]],"date-time":"2017-06-20T13:31:46Z","timestamp":1497965506000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.hindawi.com\/journals\/tswj\/2012\/726568\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012]]},"references-count":8,"alternative-id":["726568","726568"],"URL":"https:\/\/doi.org\/10.1100\/2012\/726568","relation":{},"ISSN":["1537-744X"],"issn-type":[{"value":"1537-744X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012]]}}}