SynthesisCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2014
Effectiveness of quality improvement strategies for coordination of care to reduce use of health care services: a systematic review and meta-analysis.
Synthesis in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
67 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Effectiveness of quality improvement interventions in improving cardiovascular disease-related outcomes in primary and tertiary care: A systematic review and meta-analyses.BMC primary care · 2025Pooled it
- Promising algorithms to perilous applications: a systematic review of risk stratification tools for predicting healthcare utilisation.BMJ health & care informatics · 2024Pooled it
- Systematic Review of Care Coordination Interventions Linking Health and Social Services for High-Utilizing Patient Populations.Population health management · 2022Pooled it
- EPA guidance on the quality of mental health services: A systematic meta-review and update of recommendations focusing on care coordination.European psychiatry : the journal of the Association of European Psychiatrists · 2020Pooled it
- Mapping variation in intervention design: a systematic review to develop a program theory for patient navigator programs.Systematic reviews · 2019Pooled it
- Diabetes Canada 2018 clinical practice guidelines: Key messages for family physicians caring for patients living with type 2 diabetes.Canadian family physician Medecin de famille canadien · 2019Guideline
- Pooled it
- Coordination of oral anticoagulant care at hospital discharge (COACHeD): pilot randomised controlled trial.BMJ open · 2024Trial
- Scaling and sustaining COVID-19 vaccination through meaningful community engagement and care coordination for underserved communities: hybrid type 3 effectiveness-implementation sequential multiple assignment randomized trial.Implementation science : IS · 2023Trial
- Development and delivery of an allied health team intervention for older adults in the emergency department: A process evaluation.PloS one · 2022Trial
- Trial
- Brief case management versus usual care for frequent users of emergency departments: the Coordinated Access to Care from Hospital Emergency Departments (CATCH-ED) randomized controlled trial.BMC health services research · 2016Trial
- A comparison of patient self-referrals and general practitioner referrals to the emergency department in Ireland during the COVID-19 pandemic: secondary data analysis of the "Better Data, Better Planning" study.Irish journal of medical science · 2026Article
- Health care utilization and costs among coordinated care patients in Southeastern Ontario: A difference-in-differences study of a double propensity score-matched cohort.Journal of health services research & policy · 2025Article
- Factors Affecting Adherence in Allergic Disorders and Strategies for Improvement.The journal of allergy and clinical immunology. In practice · 2024Review
- Enhancing Care Coordination in Oncology and Nononcology Thoracic Surgery Care Pathways Through a Digital Health Solution: Mixed Methods Study.JMIR formative research · 2024Article
- Non-emergency department (ED) interventions to reduce ED utilization: a scoping review.BMC emergency medicine · 2024Article
- Physician perspectives of the community paramedicine at clinic (CP@clinic) and my care plan app (myCP app) for older adults.BMC primary care · 2024Article
- A mapping review of interventions to address patients who frequently seek care in the emergency department.BMC emergency medicine · 2024Article
- Management of cancer cachexia towards optimizing care delivery and patient outcomes.Asia-Pacific journal of oncology nursing · 2023Review
7 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundFrequent users of health care services are a relatively small group of patients who account for a disproportionately large amount of health care utilization. We conducted a meta-analysis of the effectiveness of interventions to improve the coordination of care to reduce health care utilization in this patient group.
methodsWe searched MEDLINE, Embase and the Cochrane Library from inception until May 2014 for randomized clinical trials (RCTs) assessing quality improvement strategies for the coordination of care of frequent users of the health care system. Articles were screened, and data abstracted and appraised for quality by 2 reviewers, independently. Random effects meta-analyses were conducted.
resultsWe identified 36 RCTs and 14 companion reports (total 7494 patients). Significantly fewer patients in the intervention group than in the control group were admitted to hospital (relative risk [RR] 0.81, 95% confidence interval [CI] 0.72-0.91). In subgroup analyses, a similar effect was observed among patients with chronic medical conditions other than mental illness, but not among patients with mental illness. In addition, significantly fewer patients 65 years and older in the intervention group than in the control group visited emergency departments (RR 0.69, 95% CI 0.54-0.89).
interpretationWe found that quality improvement strategies for coordination of care reduced hospital admissions among patients with chronic conditions other than mental illness and reduced emergency department visits among older patients. Our results may help clinicians and policy-makers reduce utilization through the use of strategies that target the system (team changes, case management) and the patient (promotion of self-management).
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.