A small population of patients are responsible for the majority of Ontario's acute healthcare costs – high-users of acute care. At our institution, high-users were divided into those who persisted in their high use across more than six months and those who did not. Persistent users were more likely to live alone, have more than three comorbidities, take more than five medications and be admitted for chronic diseases. In a survey of their family physicians, 58% believed no interventions could have prevented readmissions; however, useful strategies such as patient education, surgical rapid access clinics and increased mental health supports were proposed.