Effectiveness of a targeted telephone-based case management service on activity in an Emergency Department in the UK: a pragmatic difference-in-differences evaluation

Elston, Julian; Gradinger, Felix; Streeter, Adam; Macey, Stephen; Martin, Susan K.

doi:10.1186/s12913-022-08415-2

Cited by 4 publications

(4 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There were no qualitative studies identified. Thirty-five (35) were from the US [ 14 , 16 , 26 – 58 ], five were from Canada [ 59 – 63 ], three were from each of the UK [ 64 – 66 ] and Australia [ 67 – 69 ], two were from each of Sweden [ 15 , 70 ], Taiwan [ 71 , 72 ], and Spain [ 73 , 74 ], and one was from each of Belgium [ 75 ], Denmark [ 76 ], Portugal [ 77 ], the Netherlands [ 18 ], Singapore [ 78 ], and Switzerland [ 79 ], Fig. 2 .…”

Section: Resultsmentioning

confidence: 99%

“…Study population size varied widely, ranging from seven participants to over 100,000. Fifteen studies had a study population of less than 100 [ 14 , 26 , 30 , 34 , 36 , 41 , 44 , 47 , 51 , 57 , 62 , 65 , 66 , 68 , 71 ], 24 had a study population of 100–500 [ 15 , 16 , 27 , 28 , 32 , 33 , 38 , 40 , 42 , 43 , 48 – 50 , 53 , 55 , 58 – 61 , 63 , 67 , 72 , 77 , 79 ], six had a study population of 500–1,000 [ 31 , 45 , 64 , 74 , 78 , 80 ], and 13 had a study population of more than 1,000 [ 18 , 29 , 36 , 37 , 39 , 46 , 52 , 54 , 56 , 69 , 70 , 75 , 76 ], Fig. 2 .…”

Section: Resultsmentioning

confidence: 99%

“…Additionally, 16 interventions were for “frequent users” as defined by the authors [ 14 – 16 , 28 , 39 , 41 , 42 , 47 , 49 , 55 , 64 , 65 , 68 , 70 , 77 , 79 ]. The definition of “frequent user” varied; some authors used patients with a specified number of visits in the last 12 [ 16 , 47 , 49 , 55 , 77 , 79 ] or six months [ 15 , 39 , 41 , 70 ], the number of visits during multiple periods of time [ 14 , 28 , 42 ], or the most frequent users over a period [ 65 , 68 ], such as the top 20 most frequent users in one quarter [ 68 ].…”

Section: Resultsmentioning

confidence: 99%

“…Several interventions were utilized in the literature, and many studies reported multi-faceted interventions, Table 1 . Overall, 36 studies reported on continuation of care interventions: 12 reported on care plans [ 15 , 26 , 28 , 30 , 38 , 41 , 42 , 45 , 49 , 68 , 70 , 75 ], nine reported on case management [ 14 , 15 , 44 , 47 , 55 , 63 , 64 , 72 , 79 ], eight reported on care coordination [ 16 , 39 , 48 , 50 , 58 , 65 , 69 , 77 ], six reported on follow-up phone calls [ 18 , 30 , 35 , 36 , 60 , 67 ], and one reported on a care transition intervention [ 51 ]. Seventeen interventions reported on additional services in the ED: four each reported on education [ 34 , 45 , 61 , 67 ] and geriatric assessment [ 72 , 75 , 76 , 78 ], two each reported on physical therapy services [ 27 , 29 ], specialist consultations [ 31 , 76 ], and medication review [ 27 , 74 ], and one each reported on early assessment and intervention [ 40 ], counselling [ 60 ], and telepsychiatry [ 46 ].…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

A mapping review of interventions to address patients who frequently seek care in the emergency department

Memedovich,

Asante,

Khan

et al. 2024

BMC Emerg Med

View full text Add to dashboard Cite

Background The high utilization of acute care services, particularly emergency departments (ED), continues to be a significant concern for healthcare providers. Numerous approaches have been studied to meet the care needs of patients who frequently seek care in the ED; however, there is no comprehensive review of the current literature base. As such, a current understanding of the interventions initiated within the ED to address the needs of frequent users is required. This mapping review had three objectives: identify the characteristics associated with the need to frequently seek care in the ED; identify interventions implemented to address the needs of this population; and identify gaps in the current evidence base. Methods A knowledge map was created by scoping the literature to identify characteristics associated with frequent ED use and interventions implemented to address frequent use. Then, a literature search was conducted to determine what has been implemented by EDs to reduce frequent ED use. The literature was searched from 2013 to January 2023. MeSH terms and keywords were used to identify relevant studies. Studies implementing an intervention for those with characteristics associated with frequent ED use and reporting on ED use were included. Results Twenty-three (23) controlled trials and 35 observational studies were included. The most common populations were older adults, those with chronic conditions, and generic “frequent users”. No studies assessed Indigenous Peoples or racial minorities, and few assessed patients with a disability or patients experiencing homelessness. The most common interventions were referrals, care plans, case management, care coordination, and follow-up phone calls. Most studies reported ED revisits, hospitalization, costs, length-of-stay, or outpatient utilization. Few assessed patient or staff perspectives. About one-third of studies (n = 24) reported significant reductions in ED revisits. Conclusions Similar interventions, mainly focused on care coordination and planning, have been implemented to address frequent use of the ED. There are still significant gaps in the populations that have been studied. Efforts now must be undertaken to study more diverse populations whose care needs are not being met elsewhere and thus frequent the ED often.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

A mapping review of interventions to address patients who frequently seek care in the emergency department

Memedovich,

Asante,

Khan

et al. 2024

BMC Emerg Med

View full text Add to dashboard Cite

show abstract

Intensity of Social Needs Case Management Services and Changes in Hospital and Emergency Department Use Among Adult Medicaid Beneficiaries

Guo,

Brown,

Rodriguez

et al. 2024

Medical Care

View full text Add to dashboard Cite

Objectives: We identify the association between high- and low-intensity case management services on hospital and emergency department (ED) use among CommunityConnect patients. Background: Social needs case management services vary in intensity, including the modality, workforce specialization, and maximum caseload. CommunityConnect is a social needs case management program implemented by Contra Costa Health, a county safety-net health system in California’s San Francisco Bay Area. Methods: Due to the endogeneity of high-intensity services assigned to high-risk patients, we instrument for service intensity using the number of specialist case managers hired each month of enrollment. Zero-inflated negative binomial models with 2-stage residual inclusion estimated total and avoidable hospital admissions and ED visits 12 months post-enrollment for adult Medicaid beneficiaries enrolled between August 2017 and December 2018 (n = 19,782). Results: Compared with low-intensity case management, high-intensity services were associated with a reduction in the incidence rates of inpatient admissions [incidence rate ratio (IRR) = 0.341, 95% CI: 0.106–1.102; P = 0.072], ED visits (IRR = 0.608, 95% CI: 0.188–1.965; P = 0.058), and avoidable ED visits (IRR = 0.579, 95% CI: 0.179–1.872; P = 0.091). No significant association was found between service intensity and the likelihood of an event being an excess zero. Conclusions: High-intensity social needs case management may be more effective than low-intensity service at reducing health care use for individuals with non-zero use, suggesting that intensive case management may be especially helpful in supporting discharge and transitions of care.

show abstract

Non-emergency department (ED) interventions to reduce ED utilization: a scoping review

Nummedal,

King,

Uleberg

et al. 2024

BMC Emerg Med

View full text Add to dashboard Cite

Background Emergency department (ED) crowding is a global burden. Interventions to reduce ED utilization have been widely discussed in the literature, but previous reviews have mainly focused on specific interventions or patient groups within the EDs. The purpose of this scoping review was to identify, summarize, and categorize the various types of non-ED-based interventions designed to reduce unnecessary visits to EDs. Methods This scoping review followed the JBI Manual for Evidence Synthesis and the PRISMA-SCR checklist. A comprehensive structured literature search was performed in the databases MEDLINE and Embase from 2008 to March 2024. The inclusion criteria covered studies reporting on interventions outside the ED that aimed to reduce ED visits. Two reviewers independently screened the records and categorized the included articles by intervention type, location, and population. Results Among the 15,324 screened records, we included 210 studies, comprising 183 intervention studies and 27 systematic reviews. In the primary studies, care coordination/case management or other care programs were the most commonly examined out of 15 different intervention categories. The majority of interventions took place in clinics or medical centers, in patients’ homes, followed by hospitals and primary care settings - and targeted patients with specific medical conditions. Conclusion A large number of studies have been published investigating interventions to mitigate the influx of patients to EDs. Many of these targeted patients with specific medical conditions, frequent users and high-risk patients. Further research is needed to address other high prevalent groups in the ED - including older adults and mental health patients (who are ill but may not need the ED). There is also room for further research on new interventions to reduce ED utilization in low-acuity patients and in the general patient population.

show abstract

Effectiveness of a targeted telephone-based case management service on activity in an Emergency Department in the UK: a pragmatic difference-in-differences evaluation

Cited by 4 publications

References 25 publications

A mapping review of interventions to address patients who frequently seek care in the emergency department

A mapping review of interventions to address patients who frequently seek care in the emergency department

Intensity of Social Needs Case Management Services and Changes in Hospital and Emergency Department Use Among Adult Medicaid Beneficiaries

Non-emergency department (ED) interventions to reduce ED utilization: a scoping review

Contact Info

Product

Resources

About