Background Emergency department (ED) High users (HU), defined as having more than ten visits to the ED per year, are a small group of patients that use a significant proportion of ED resources. The High Users Resolution Group (GRHU) identifies and provides care to HU to improve their health conditions and reduce the frequency of ED visits by delivering patient-centered case management integrated care. The main objective of this study was to measure the impact of the GRHU intervention in reducing ED visits, outpatient appointments, and hospitalizations. As secondary objectives, we aimed to compare the GRHU intervention costs against its potential savings or additional costs. Finally, we intend to study the impact of this intervention across different groups of patients. Methods We studied the changes triggered by the GRHU program in a retrospective, non-controlled before-after analysis of patients’ hospital utilization data on 6 and 12-month windows from the first appointment. Results A total of 238 ED HU were intervened. A sample of 152 and 88 patients was analyzed during the 6 and 12-month window, respectively. On the 12-month window, GRHU intervention was associated with a statistically significant reduction of 51% in ED visits and hospitalizations and a non-statistically significant increase in the total number of outpatient appointments. Overall costs were reduced by 43.56%. We estimated the intervention costs to be €79,935.34. The net cost saving was €104,305.25. The program’s Return on Investment (ROI) was estimated to be €2.3. Conclusion Patient-centered case management for ED HU seems to effectively reduce ED visits and hospitalizations, leading to better use of resources.

Background: Emergency department (ED) High users (HU), defined as having more than ten visits to the ED per year, are a small group of patients that use a significant proportion of ED resources. The High Users Resolution Group(GRHU) identifies and provides care toHUto improve their health situation and reduce their visit frequency to the ED by delivering patient-centered, case management integrated care. Objectives: The main objective of this study was to measure the impact in terms of hospital visits of the GRHU intervention. Additionally, we aim to compare the program costs against its potential savings or additional costs. Finally, we intend to study the impact of the intervention across different groups of patients. Methods: We studied The changes triggered by the GRHU program in a retrospective non-controlled before-after analysis of patients’ hospital utilization data on six and 12-month windows from the first appointment. The GRHU team provided the patients’ and cost data. Results: A total of 238 EDHUwere intervened. A sample of 88 patients was analyzed on the 12-month window as they fulfilled all inclusion criteria. This intervention was associated with a statistically significant reduction of 51% in ED use and hospitalizations, and a non-statistically significant increase in the total number of outpatient appointments. Overall costs reduced 43.56%. We estimated the intervention costs to be€162,847.82. The net cost saving was€104,305.25. The program’s Return on Investment (ROI) was estimated to be€2.3. Conclusions: Patient-centered case management for EDHUseems to effectively reduce ED visits and hospitalizations, leading to the more appropriate use of resources.