BACKGROUND: In 2008, Kern Medical Center established a Care Management Program (CMP) for low-income adults identified as frequent users of hospital services. Frequent users are defined as having 4 or more emergency department (ED) visits or admissions, 3 or more admissions, or 2 or more admissions and 1 ED visit within 1 year. The CMP helps patients access primary care and medical and social resources. OBJECTIVE: To determine whether the CMP reduces ED visits and hospitalizations among frequent users. METHOD: Between August 2007 and January 2010, a retrospective analysis was conducted using Kern Medical Center encounter data. ED visits and inpatient visits were compared pre- and postenrollment for care managed patients (n = 98). The analysis included a comparison group (n = 160) of frequent users matched on the basis of race and age. Multivariate analyses were performed to evaluate the difference in utilization between groups, and to adjust for potential group differences. RESULTS: There was a reduction in the median number of ED visits per year from 6.0 ± 5.0 (median ± interquartile range) pre-enrollment to 1.7 ± 3.3 [corrected] postenrollment (P < 0.0001). The difference in inpatient admissions pre- and postenrollment was 0.0 ± 1.0 (P < 0.0001). After adjusting for multiple factors, multivariate analysis demonstrated that care managed patients had a 32% lower risk of visiting the ED than the comparison group (P < 0.0001). There was no difference in inpatient admissions between groups. CONCLUSIONS: CMP that helps patients navigate the health care system and access social and medical resources show significant promise in reducing ED utilization.
BACKGROUND: In 2008, Kern Medical Center established a Care Management Program (CMP) for low-income adults identified as frequent users of hospital services. Frequent users are defined as having 4 or more emergency department (ED) visits or admissions, 3 or more admissions, or 2 or more admissions and 1 ED visit within 1 year. The CMP helps patients access primary care and medical and social resources. OBJECTIVE: To determine whether the CMP reduces ED visits and hospitalizations among frequent users. METHOD: Between August 2007 and January 2010, a retrospective analysis was conducted using Kern Medical Center encounter data. ED visits and inpatient visits were compared pre- and postenrollment for care managed patients (n = 98). The analysis included a comparison group (n = 160) of frequent users matched on the basis of race and age. Multivariate analyses were performed to evaluate the difference in utilization between groups, and to adjust for potential group differences. RESULTS: There was a reduction in the median number of ED visits per year from 6.0 ± 5.0 (median ± interquartile range) pre-enrollment to 1.7 ± 3.3 [corrected] postenrollment (P < 0.0001). The difference in inpatient admissions pre- and postenrollment was 0.0 ± 1.0 (P < 0.0001). After adjusting for multiple factors, multivariate analysis demonstrated that care managed patients had a 32% lower risk of visiting the ED than the comparison group (P < 0.0001). There was no difference in inpatient admissions between groups. CONCLUSIONS: CMP that helps patients navigate the health care system and access social and medical resources show significant promise in reducing ED utilization.
Authors: Catherine Hudon; Maud-Christine Chouinard; Kris Aubrey-Bassler; Nazeem Muhajarine; Fred Burge; Paula Louise Bush; Alya Danish; Vivian R Ramsden; France Légaré; Line Guénette; Paul Morin; Mireille Lambert; Fiona Fick; Olivia Cleary; Véronique Sabourin; Mike Warren; Pierre Pluye Journal: Ann Fam Med Date: 2020-05 Impact factor: 5.166
Authors: Catherine Hudon; Maud-Christine Chouinard; Pierre Pluye; Reem El Sherif; Paula Louise Bush; Benoît Rihoux; Marie-Eve Poitras; Mireille Lambert; Hervé Tchala Vignon Zomahoun; France Légaré Journal: Ann Fam Med Date: 2019-09 Impact factor: 5.166
Authors: Lesley J J Soril; Laura E Leggett; Diane L Lorenzetti; Tom W Noseworthy; Fiona M Clement Journal: PLoS One Date: 2015-04-13 Impact factor: 3.240
Authors: Vladimir Khanassov; Pierre Pluye; Sarah Descoteaux; Jeannie L Haggerty; Grant Russell; Jane Gunn; Jean-Frederic Levesque Journal: Int J Equity Health Date: 2016-10-10