Evidence map›Paper›PMID 36100864›Full record

ArticleBMC emergency medicine2022

Case management intervention of high users of the emergency department of a Portuguese hospital: a before-after design analysis.

Simão Gonçalves, Francisco von Hafe, Flávio Martins, Carla Menino, Maria José Guimarães, Andreia Mesquita, Susana Sampaio, Ana Rita Londral

Open access · goldAbstract read
In one paragraph

Article in BMC emergency medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
2.0field-weighted citation impact, top 14% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Simão GonçalvesValue for Health CoLAB, NOVA Medical School, Lisbon, Portugal.
Francisco von HafeValue for Health CoLAB, NOVA Medical School, Lisbon, Portugal. francisco.vonhafe@vohcolab.org.
Flávio MartinsValue for Health CoLAB, NOVA Medical School, Lisbon, Portugal.
Carla MeninoHospital Garcia de Orta, EPE, Almada, Portugal.
Maria José GuimarãesUnidade de Saúde Familiar Cova da Piedade, Almada, Portugal.
Andreia MesquitaHospital Garcia de Orta, EPE, Almada, Portugal.
Susana SampaioHospital Garcia de Orta, EPE, Almada, Portugal.
Ana Rita LondralValue for Health CoLAB, NOVA Medical School, Lisbon, Portugal.
Universidade Nova de Lisboa · PTHospital Garcia de Orta · PTCâmara Municipal de Almada · PT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEmergency 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.

methodsWe 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.

resultsA 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.

conclusionPatient-centered case management for ED HU seems to effectively reduce ED visits and hospitalizations, leading to better use of resources.

Indexed as

Case ManagementEmergency Service, HospitalHospitalsHumansPortugalRetrospective StudiesCase management; Integrated care; High users; Emergency department; Costs; Healthcare system sustainability

Identifiers

PMID36100864
PMCPMC9470068
OpenAlexW4295760290

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.