The effect of multidisciplinary case management on selected outcomes for frequent attenders at an emergency department

2006 ◽  
Vol 184 (12) ◽  
pp. 602-606 ◽  
Author(s):  
Georgina Ann Phillips ◽  
David S Brophy ◽  
Tracey J Weiland ◽  
Antony J Chenhall ◽  
Andrew W Dent
Keyword(s):  
Emergency Department ◽  
Case Management ◽  
Frequent Attenders

scholarly journals Measuring the impact of an acute visiting scheme on emergency department attendances – a pre-post cohort design

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Axel Kaehne ◽  
Paula Keating
Keyword(s):  
Emergency Department ◽  
Service Use ◽  
Emergency Department Visits ◽  
Service Utilisation ◽  
Specific Patient ◽  
Access Points ◽  
Latent Demand ◽  
Frequent Attenders ◽  
Cohort Design ◽  
The Impact

Abstract Background Emergency department (ED) attendances are contributing to rising costs of the National Health Service (NHS) in England. Critically assessing the impact of new services to reduce emergency department use can be difficult as new services may create additional access points, unlocking latent demand. The study evaluated an Acute Visiting Scheme (AVS) in a primary care context. We asked if AVS reduces overall ED demand and whether or not it changed utilisation patterns for frequent attenders. Method The study used a pre post single cohort design. The impact of AVS on all-cause ED attendances was hypothesised as a substitution effect, where AVS duty doctor visits would replace emergency department visits. Primary outcome was frequency of ED attendances. End points were reduction of frequency of service use and increase of intervals between attendances by frequent attenders. Results ED attendances for AVS users rose by 47.6%. If AVS use was included, there was a more than fourfold increase of total service utilisation, amounting to 438.3%. It shows that AVS unlocked significant latent demand. However, there was some reduction in the frequency of ED attendances for some patients and an increase in time intervals between ED attendances for others. Conclusion The study demonstrates that careful analysis of patient utilisation can detect a differential impact of AVS on the use of ED. As the new service created additional access points for patients and hence introduces an element of choice, the new service is likely to unlock latent demand. This study illustrates that AVS may be most useful if targeted at specific patient groups who are most likely to benefit from the new service.

The impact of frequent attenders on a UK emergency department

2010 ◽  
Vol 17 (6) ◽  
pp. 332-336 ◽  
Author(s):  
Alexandra Dent ◽  
Glenys Hunter ◽  
Andrew Philip Webster
Keyword(s):  
Emergency Department ◽  
Frequent Attenders ◽  
The Impact

scholarly journals Indicação da Terapia de Reidratação Oral no setor de emergência: decisão baseada na clínica?

2010 ◽  
Vol 28 (2) ◽  
pp. 215-220 ◽  
Author(s):  
Auxiliadora Damianne P. V. da Costa ◽  
Gisélia Alves P. da Silva
Keyword(s):  
Emergency Department ◽  
Case Management ◽  
Cochrane Collaboration ◽  
Oral Rehydration Therapy ◽  
Oral Rehydration ◽  
Diarrhea Case

OBJETIVO: Revisar a literatura acerca da indicação da terapia de reidratação oral (TRO) no contexto do Setor de Emergência, buscando fatores inerentes à formação do médico, à atitude do cuidador e, finalmente, à dinâmica do próprio serviço como determinantes à sua aplicação. FONTES DE DADOS: Revisão não-sistemática da literatura incluindo artigos originais e meta-análises, nos idiomas inglês, português e espanhol, a partir das bases de dados Pubmed/Medline, Cochrane Collaboration, Lilacs e SciELO, no período de 1990 a 2008. Foram utilizados os termos "oral rehydration therapy", "diarrhea case management", "emergency department" e palavras relacionadas. SÍNTESE DOS DADOS: Realizada em local apropriado, a TRO mostrou eficácia semelhante à terapia venosa no restabelecimento do nível de hidratação em crianças com diarreia aguda no Setor de Emergência. O tempo de formado e a experiência profissional, o conhecimento e o treinamento no manejo da diarreia aguda mostraram associação à utilização da TRO. Entretanto, relatos de inconveniência de sua administração no Setor de Emergência incluem falta de espaço físico e pressão assistencial, sugerindo, ao mesmo tempo, inadequação estrutural e uso inapropriado do serviço nesses casos. A relação com o cuidador também influencia na decisão médica, com o relato de desconfiança deste quanto à eficácia da terapia sendo citado como barreira à sua indicação. CONCLUSÕES: A subutilização da TRO no Setor de Emergência está associada a fatores extrínsecos à formação médica, como questões estruturais e fatores inerentes à relação com o cuidador diante das suas expectativas quanto à terapia.

A telephone-based case-management intervention reduces healthcare utilization for frequent emergency department visitors

2013 ◽  
Vol 20 (5) ◽  
pp. 327-334 ◽  
Author(s):  
Peter Reinius ◽  
Magnus Johansson ◽  
Ann Fjellner ◽  
Joachim Werr ◽  
Gunnar Öhlén ◽  
...  
Keyword(s):  
Emergency Department ◽  
Case Management ◽  
Healthcare Utilization ◽  
Management Intervention ◽  
Case Management Intervention

Case management: the participation of nurse in the first attendiment at emergency department

2005 ◽  
Vol 4 (2) ◽  
Author(s):  
Marcia Rejane da Silva Valentim ◽  
Mauro Leonardo S. C. dos Santos
Keyword(s):  
Emergency Department ◽  
Case Management

Frequent attendance: a Clinical and Epidemiological Study

2016 ◽  
Vol 33 (S1) ◽  
pp. S442-S443
Author(s):  
S. López-Romeo ◽  
G. Ledesma-Iparraguirre
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Retrospective Study ◽  
Emergency Services ◽  
Care Facility ◽  
Health Care Facility ◽  
Frequent Attenders ◽  
Frequent Attendance ◽  
Competing Interest ◽  
New Strategies

BackgroundFrequent attenders (F a) are patients who attend a health care facility repeatedly. The frequency of frequent attendance at emergencies department has been defined as 4 or more attendances/annum. F a are few in number but they produce a high number of attendances.aimsTo determine prevalence of F a, mean attendances/year generated by F a and frequency of visits by months.Methodsa retrospective study was performed on psychiatry's emergency department database from January until December 2013. F a was defined as those with ≥ 4 attendances at emergency services in a year.Prevalence of F a, attendances’ prevalence, diagnosis’ prevalence, Mean attendances generated by F a and frequency of visits by months were analysed.Resultsamong 4824 attendances we found 181 F as (5.98%). Men represented 50.80% and women 49.20%. F a presented a mean of 6.33 attendances/year, while non-F a presented a mean of 1.29 attendances/year.in accordance with frequency of visits by months, it was observed that number of attendances was increased in april and May, in both F a and non-F a.ConclusionPrevalence of F a was 5.98%, F a generated a 23.74% of attendances. Most prevalent F a’ diagnoses were: anxiety disorder, personality disorder non-specified and schizophrenia.F a at emergency department contributes to overcrowd them. for this reason, it is important to take into account these results to develop new strategies to improve F a’ attention and prevent its occurrence.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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