A Case Management Study Targeted to Reduce Health Care Utilization for Frequent Emergency Department Visitors

Study Overview
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Brief Summary
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The aim of the study is to determine whether a nurse-managed telephone-based case-management intervention can reduce healthcare utilization and improve self-assessed health status in frequent emergency department users.

Detailed Description
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The study tests a nurse-run case-management intervention targeted towards frequent emergency department visitors. The aim is to reduce visits to emergency departments as well as to improve quality of life by facilitating coping mechanisms as well as redirecting these patients to more suitable health care facilities.

Official Title
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A Case Management Study Targeted to Reduce Health Care Utilization for Frequent Emergency Department Visitors

Conditions
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The Focus is to Investigate Effect of a Case Management Interventions in Frequent Visitors to Emergency Departments

Intervention / Treatment
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* Behavioral: Case-management intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Recent history of frequent visits to emergency department Anticipated sustained high visit frequency Living in one of five Swedish counties where trial is ongoing Exclusion Criteria: Moribund patients Psychosis Severe hearing impairment or language difficulties Other factors that may make it impossible or impractical for a patient to participate in the study

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Case-management intervention<br>Receiving nurse-managed intervention | Behavioral: Case-management intervention<br>* The participants in the intervention group receives a nurse-managed case-management intervention that is regularly delivered by telephone or, when necessary, in person.<br>|
| No Intervention: Control arm<br>Control group not receiving any intervention | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of outpatient visits to medical doctor |  | During first two years of follow-up | 
| Number of hospitalizations |  | During first two years of follow-up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mortality |  | During first two years of follow-up | 
| Length of hospital stay |  | During first two years of follow-up | 
| Total health care costs |  | During first two years of follow-up | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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case management, disease management, emergency, department