Background and Objective:
Frequent users are patients who repeatedly and inappropriately access the emergency department (ED), with low grade symptoms potentially treated outside the hospital setting.They contribute to increase the ED extra costs and risk to compromise the quality of hospital services.This study aims at investigating the phenomenon of frequent user in Rome, defining the profile and comparing the accesses to EDs.

Methods:
The analysis was carried out considering the accesses to 13 EDs in 2021 in the Local Health Authority Roma 1 geographical area.According to the Italian Ministry of Health’s cathegories, the EDs were classified into three levels of complexity (I, II, III level).A digital app collected demographic, geographical and clinical data,using the Lazio Region official data flows.Records were pseudo-anonymized.According to the literature, 3 categories of frequent user were identified: ≥4 access, ≥7 access, ≥10 access per year.Chi-squared tests were conducted to verify the differences between the three EDs cathegories in terms of the proportion of frequent user accesses.

Results:
A total of 110.761 ED accesses were registered and 81.406 users were included. ≥4 access user category represented 1,4% of all users, ≥7 access was 0,7%, ≥10 access was 0,2%. 77% were registered as not an emergency/urgency, 54% of users didn’t need hospitalization. The mostly recorded diseases were chronic pathologies,often with social and mental health-related issues.Significant differences (p