Case management intervention of high users of the emergency department of a Portuguese hospital

Detalhes bibliográficos
Autor(a) principal: Gonçalves, Simão
Data de Publicação: 2022
Outros Autores: von Hafe, Francisco, Martins, Flávio, Menino, Carla, Guimarães, Maria José, Mesquita, Andreia, Sampaio, Susana, Londral, Ana Rita
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10362/144513
Resumo: Funding FVH, FM, and ARL acknowledge funding from the Portuguese National Funding Agency for Science, Research, and Technology (FCT) and public ESF funding with reference LISBOA-05–3559-FSE-000003. SG acknowledges funding from DSAIPA project FrailCare.AI (DSAIPA/0106/2019/02) with the fnancial support of FCT.
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spelling Case management intervention of high users of the emergency department of a Portuguese hospitala before-after design analysisCase managementIntegrated careHigh usersEmergency departmentCostsHealthcare system sustainabilityEmergency MedicineFunding FVH, FM, and ARL acknowledge funding from the Portuguese National Funding Agency for Science, Research, and Technology (FCT) and public ESF funding with reference LISBOA-05–3559-FSE-000003. SG acknowledges funding from DSAIPA project FrailCare.AI (DSAIPA/0106/2019/02) with the fnancial support of FCT.BACKGROUND: Emergency 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. METHODS: We 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. RESULTS: A 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. CONCLUSION: Patient-centered case management for ED HU seems to effectively reduce ED visits and hospitalizations, leading to better use of resources.Comprehensive Health Research Centre (CHRC) - pólo NMSNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)NOVALincsDI - Departamento de InformáticaFaculdade de Ciências e Tecnologia (FCT)RUNGonçalves, Simãovon Hafe, FranciscoMartins, FlávioMenino, CarlaGuimarães, Maria JoséMesquita, AndreiaSampaio, SusanaLondral, Ana Rita2022-10-06T22:17:44Z2022-09-132022-09-13T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article1application/pdfhttp://hdl.handle.net/10362/144513engPURE: 46744213https://doi.org/10.1186/s12873-022-00716-3info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T05:24:11Zoai:run.unl.pt:10362/144513Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:51:36.185100Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Case management intervention of high users of the emergency department of a Portuguese hospital
a before-after design analysis
title Case management intervention of high users of the emergency department of a Portuguese hospital
spellingShingle Case management intervention of high users of the emergency department of a Portuguese hospital
Gonçalves, Simão
Case management
Integrated care
High users
Emergency department
Costs
Healthcare system sustainability
Emergency Medicine
title_short Case management intervention of high users of the emergency department of a Portuguese hospital
title_full Case management intervention of high users of the emergency department of a Portuguese hospital
title_fullStr Case management intervention of high users of the emergency department of a Portuguese hospital
title_full_unstemmed Case management intervention of high users of the emergency department of a Portuguese hospital
title_sort Case management intervention of high users of the emergency department of a Portuguese hospital
author Gonçalves, Simão
author_facet Gonçalves, Simão
von Hafe, Francisco
Martins, Flávio
Menino, Carla
Guimarães, Maria José
Mesquita, Andreia
Sampaio, Susana
Londral, Ana Rita
author_role author
author2 von Hafe, Francisco
Martins, Flávio
Menino, Carla
Guimarães, Maria José
Mesquita, Andreia
Sampaio, Susana
Londral, Ana Rita
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Comprehensive Health Research Centre (CHRC) - pólo NMS
NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
NOVALincs
DI - Departamento de Informática
Faculdade de Ciências e Tecnologia (FCT)
RUN
dc.contributor.author.fl_str_mv Gonçalves, Simão
von Hafe, Francisco
Martins, Flávio
Menino, Carla
Guimarães, Maria José
Mesquita, Andreia
Sampaio, Susana
Londral, Ana Rita
dc.subject.por.fl_str_mv Case management
Integrated care
High users
Emergency department
Costs
Healthcare system sustainability
Emergency Medicine
topic Case management
Integrated care
High users
Emergency department
Costs
Healthcare system sustainability
Emergency Medicine
description Funding FVH, FM, and ARL acknowledge funding from the Portuguese National Funding Agency for Science, Research, and Technology (FCT) and public ESF funding with reference LISBOA-05–3559-FSE-000003. SG acknowledges funding from DSAIPA project FrailCare.AI (DSAIPA/0106/2019/02) with the fnancial support of FCT.
publishDate 2022
dc.date.none.fl_str_mv 2022-10-06T22:17:44Z
2022-09-13
2022-09-13T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/144513
url http://hdl.handle.net/10362/144513
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv PURE: 46744213
https://doi.org/10.1186/s12873-022-00716-3
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 1
application/pdf
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
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