Effectiveness of Case Management Strategies in Reducing Emergency Department Visits in Frequent User Patient Populations: A Systematic Review
Abstract
Background Case management (CM) is a commonly cited intervention aimed at reducing Emergency Department (ED) utilization by "frequent users," a group of patients that utilize the ED at disproportionately high rates. Studies have investigated the impact of CM on a variety of outcomes in this patient population. Objectives We sought to examine the evidence of the effectiveness of the CM model in the frequent ED user patient population. We reviewed the available literature focusing on the impact of CM interventions on ED utilization, cost, disposition, and psychosocial variables in frequent ED users. Discussion Although there was heterogeneity across the 12 studies investigating the impact of CM interventions on frequent users of the ED, the majority of available evidence shows a benefit to CM interventions. Reductions in ED visitation and ED costs are supported with the strongest evidence. Conclusion CM interventions can improve both clinical and social outcomes among frequent ED users.
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Reducing unnecessary emergency department visits is recognised as an important policy goal due to the potential for significant cost savings.
“Reducing unnecessary ED visits is recognised as an important policy goal due to the potential for significant cost savings [54].”
Many programs to reduce emergency department utilisation focus on primary care access, case management support and chronic conditions self-management education.
“A brief review of the literature indicates that many programs to reduce ED utilisation focus on primary care access, case management support and chronic conditions self-management education [45,48,54].”
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Reducing Frequent Visits to the Emergency Department: A Systematic Review of Interventions
Soril, L. J. J., Leggett, L. E., Lorenzetti, D. L., Noseworthy, T. W., & Clement, F. M. (2015) · PLOS ONE · doi:10.1371/journal.pone.0123660 · Cited by 251 · see citing works
"Hospital was the only option": Experiences of frequent emergency department users in mental health.
Wise-Harris, D., Pauly, D., Kahan, D., Tan de Bibiana, J., Hwang, S. W., & Stergiopoulos, V. (2017) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-016-0728-3 · Cited by 126 · see citing works
Iovan, S., Lantz, P. M., Allan, K., & Abir, M. (2020) · Medical Care Research and Review · doi:10.1177/1077558719845722 · Cited by 62 · see citing works
Hudon, C., Courteau, J., Krieg, C., & Vanasse, A. (2017) · BMC Health Services Research · doi:10.1186/s12913-017-2453-3 · Cited by 32 · see citing works
Chiu, Y. M., Courteau, J., Dufour, I., Vanasse, A., & Hudon, C. (2023) · Scientific Reports · doi:10.1038/s41598-023-27568-6 · Cited by 20 · see citing works
Fleming, M. D., Safaeinili, N., Knox, M., Hernandez, E., Esteban, E. E., Sarkar, U., & Brewster, A. L. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-08979-z · Cited by 19 · see citing works
Ray, L., Outten, B., & Gottlieb, K. (2020) · International Journal of Circumpolar Health · doi:10.1080/22423982.2019.1705048 · Cited by 3 · see citing works
“Reducing unnecessary ED visits is recognised as an important policy goal due to the potential for significant cost savings [54].”
Background
- Authors
- Kumar, G. S., & Klein, R.
- Affiliations
- Emory University (US)
- Corresponding author
- Klein, Robin
- Venue
- The Journal of Emergency Medicine
- Publisher
- Elsevier BV
- Published
- 2013-03
- Volume
- 44
- Issue
- 3
- Pages
- 717-729
- ISSN
- 0736-4679 (ISSN-L)
- OpenAlex
- W1999718632
- Cited by
- 221
- References
- 0
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 11 · 2023: 18 · 2022: 23 · 2021: 25 · 2020: 28 · 2019: 22 · 2018: 19 · 2017: 21 · 2016: 19 · 2015: 12 · 2014: 6 · 2013: 2
- FWCI
- 1.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Journal of Emergency Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- case management, frequent emergency department users, emergency department utilization, emergency department costs, patient disposition, psychosocial outcomes, health care utilization reduction
- MeSH terms
- Emergency Service, Hospital, Health Status, Hospitalization, Humans, Socioeconomic Factors, United States, Outcome Assessment, Health Care, Models, Organizational, Hospital Costs, Case Management
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