A new study is helping identify 'frequent flyers' to the district's hospital emergency departments to better support them - and reduce pressure on services.
More than one million visits to EDs in the region over 10 years were analysed for the research, run by the University of Wollongong in partnership with the Illawarra Shoalhaven Local Health District.
Lead researcher Dr Luise Lago said with ED presentations increasing faster than population growth across the nation - and the region - researchers wanted to find out which patients were repeatedly visiting EDs, and why.
The study found some frequent attenders to the region's EDs had clocked up more than 200 visits in a decade; however Dr Lago said it also revealed some surprising findings about those repeat visitors.
"There is a widely held view among researchers, policy makers, managers and clinicians, that a large number of people repeatedly visit emergency departments year after year, taking up beds that are needed for more urgent patients," she said.
"So instead of looking at a single year, we looked back over 10 years (2005 to 2015) to analyse long-term patient patterns.
"Our study of the local hospital data revealed that instead of an estimated 10,000 frequent attenders during that time, only 600 people were ongoing frequent attenders - those who visited EDs more than seven times a year for longer than two years.
"And while it was generally thought that the majority of frequent attenders were elderly people, the study found that most were younger adults, many with mental health and drug and alcohol issues."
The study - published in the British Medical Journal BMJ Open - is already informing local and state policy - and could have implications for international practice.
In the Illawarra, the results have led to the development of a taskforce including UOW, ISLHD, primary health network Coordinare and NSW Ambulance to better co-ordinate care for frequent attenders.
"It was previously thought too overwhelming to specifically target such a large number of patients," Dr Lago said.
"However by narrowing it down to a far smaller group it enables the local health district to more easily provide intervention to those individuals, to address any gaps in their ongoing care.
"Often their needs could be better met in the community - through GPs or specialists - rather than them getting to an urgent crisis point where they need to visit the ED.
"It's about getting consistent care plans in place which will benefit them - and reduce the pressure on our EDs."
The study is titled Here one year, gone the next? Investigating persistence of frequent emergency department attendance: a retrospective study in Australia.
It utilised data on Wollongong, Shellharbour, Shoalhaven, Milton-Ulladulla hospitals, as well as the former ED at Bulli Hospital.