NCT01934322

Case Management for Frequent Users of the Emergency Department

Case Management for Frequent Users of the Emergency Department: A Randomized Controlled Trial

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 250 (actual)
• Sponsor: University of Lausanne · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

The purpose of this study is to evaluate a specific case management intervention for frequent users (FU) of Emergency Department (ED). Compared to infrequent or non-users, most of the ED-FU visitors are identified as vulnerable patients because they are more likely to be of low social and economical status, be more isolated and live alone. They report more chronic medical conditions, have a higher mortality rate and consume more healthcare resources. In the literature, interventions aimed at improving the management of ED-FU have demonstrated several positive outcomes, but there are still some knowledge gaps. The proposed project tests the hypotheses that case management intervention as compared with standard emergency care * is a more efficient use of healthcare resources and reduces ED attendance, * is cost-saving and * improves quality of life, * altogether leading to favorable cost-utility ratio.

Conditions

• Frequent Users of the Emergency Department
• Vulnerable Populations

Interventions

Type	Name	Description
OTHER	Case Management	Furnish specific assistance and to provide referrals for the patients: * If the social determinants are not adequate, the team will lend assistance for obtaining income entitlements, health insurance coverage if eligible, stable housing, schooling for children, etc. * If there are mental disturbances, the team will refer to mental health departments inside the hospital, and if necessary, to a psychiatrist, psychologist or general practitioner (GP) out in the community. * If the patient presents risk behaviors, the team will refer to substance abuse services and links to community services in order to maintain continuity of care. * In case of somatic problems, the team will find a new GP or make contact with the previous provider, contingent on the patient's consent.

Timeline

• Start date: 2012-06-01
• Primary completion: 2014-07-01
• Completion: 2014-07-01
• First posted: 2013-09-04
• Last updated: 2015-05-27

Locations

1 site across 1 country: Switzerland