PMID: 9189190Jun 1, 1997Paper

Frequent users of the emergency department: can we intervene?

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
L L SpillaneS M Schneider

Abstract

To determine whether the use of individualized patient care plans and multidisciplinary case management would decrease ED utilization by frequent ED users. The authors performed a prospective, randomized clinical trial of the impact of a care plan on ED use by adults with frequent ED visits. Patients with > 10 ED visits to a university hospital in 1993 were identified. Patients were matched for age, sex, and number of visits and then randomized into 2 groups. The control group received standard emergency care. The treatment group was managed by a multidisciplinary team and treated in the ED according to individualized care plans. ED use was tracked at the university hospital and at the other 5 community hospitals in the city. Of the 70 enrolled patients, 25 of 37 control patients and 27 of 33 treatment patients made visits to the university hospital during the 1-year study period. Only those patients with follow-up visits were included in the data analysis. Patients remaining in the control group made 247 total visits (range 1-65) to the university hospital and 179 total visits (range 0-38) to the community hospitals during the study period. Patients in the treatment group made 320 total visits (range 1-72) to the university ho...Continue Reading

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