RT Journal Article
SR Electronic
T1 Frequent users of the emergency department: a program to improve care and reduce visits
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP 1017
OP 1020
VO 162
IS 7
A1 Pope, Dorothy
A1 Fernandes, Christopher M.B.
A1 Bouthillette, France
A1 Etherington, Jeremy
YR 2000
UL http://www.cmaj.ca/content/162/7/1017.abstract
AB The authors describe a case-management program for frequent users of the emergency department. The study had a single-subject design, with evaluation for each patient of the number of visits to the emergency department for a 12-month period before referral to the program and a similar period after implementation of an individualized care plan. Referrals were made on the basis of 2 or more of the following criteria: chronic medical condition, complex medical condition, drug-seeking behaviour, violent behaviour and abusive behaviour. A multidisciplinary team developed the individualized care plans. Twenty-four patients agreed to participate. For the 12-month period before their referral, these patients accounted for a total of 616 (median 26.5) visits to the emergency department; for a similar period after implementation of the care plans, they accounted for 175 (median 6.5) visits. The difficult-case management program appeared to be effective in reducing the total number of visits to the emergency department during the study period and in improving the care for these patients.