The numbers are staggering.

The 10 heaviest users of London’s busy hospital emergency rooms racked up 801 ER trips among them in the past 10 months, one an eye-popping 180 times.

Those same patients, figures obtained by The Free Press show, more often than not end up leaving the ER before they’re treated — fed up by waits, their maladies or maybe the demons that haunt so many.

Emergency care is among the most expensive health care, but London’s heaviest ER users turn to the swamped system relentlessly — often for things doctors wouldn’t consider an emergency.

Such numbers set off alarms at the hospitals, and not just because such frequent visitors strain emergency care: They clearly weren’t getting the care they needed elsewhere.

“How do we treat them better and decrease their visits?” asked Carol Young-Ritchie, a vice-president at London Health Sciences Centre who oversees patient care and formerly directed emergency services.

It was precisely that sort of question that 14 months ago led hospital officials to try to get a better grip on who’s habitually turning to the ER, why and whether their needs would be better met with more support in the community.

The investigation, said Young-Ritchie, was just one key step in making changes. The other was reaching out to groups that might play some role in getting the heaviest ER users to rely instead on care in the community.

“Often these (community) services didn’t know (their clients) were coming to the ER so often,” Young-Ritchie said.

During quarterly meetings with community groups, hospital officials tried to pinpoint how to help patients in the community.

Some needed social housing. Others were ready to try to stop their addictions. Many lacked any contact with primary care doctors, some because they’d “burned bridges” with their behaviour with previous doctors, Young-Ritchie said.

While no one has tracked precisely how interventions have affected the number of emergency visits, she said she believes the collaboration between the hospitals and community groups is making a difference.

“How do you set them up to succeed?” she asked.

The collaboration began with a focus on those with mental illness and addiction, but LHSC hopes to eventually expand its efforts to include other frequent ER users, possibly starting with those with chronic health needs.

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OTHER FINDINGS

(From study of habitual ER patients)