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OpenTrials
Completed

NCT Number: NCT01934322

Case Management for Frequent Users of the Emergency Department

The purpose of this study is to evaluate a specific case management intervention for frequent users (FU) of Emergency Department (ED).

Compared to infrequent or non-users, most of the ED-FU visitors are identified as vulnerable patients because they are more likely to be of low social and economical status, be more isolated and live alone. They report more chronic medical conditions, have a higher mortality rate and consume more healthcare resources.

In the literature, interventions aimed at improving the management of ED-FU have demonstrated several positive outcomes, but there are still some knowledge gaps.

The proposed project tests the hypotheses that case management intervention as compared with standard emergency care

* is a more efficient use of healthcare resources and reduces ED attendance, * is cost-saving and * improves quality of life, * altogether leading to favorable cost-utility ratio.

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Key information

Conditions

Frequent Users of the Emergency Department Vulnerable Populations

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University Hospital of Lausanne

Lausanne, 1011, Switzerland

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 5 or more attendances during the previous 12 months at the Emergency Department of the University Hospital of Lausanne
  • Be capable of communicating in any of the languages spoken by the team (i.e. French, English, German, Italian and Spanish) or through a community interpreter

Exclusion criteria

  • Patients who cannot give informed consent or are ineligible to receive Case Managers services (e.g. acutely confused, acutely psychotic, intoxicated)
  • Patients who are in prison
  • Patients with a diagnose of cognitive disorders (delirium, dementia, and other cognitive disorders)
  • Patients who are not expected to survive at least 18 months after enrollment
  • Patients who will not remain in Switzerland for 12 to 18 months after enrollment
  • Family members of a participant already included

Treatment and study plan

Case management

Other

Furnish specific assistance and to provide referrals for the patients:

  • If the social determinants are not adequate, the team will lend assistance for obtaining income entitlements, health insurance coverage if eligible, stable housing, schooling for children, etc.
  • If there are mental disturbances, the team will refer to mental health departments inside the hospital, and if necessary, to a psychiatrist, psychologist or general practitioner (GP) out in the community.
  • If the patient presents risk behaviors, the team will refer to substance abuse services and links to community services in order to maintain continuity of care.
  • In case of somatic problems, the team will find a new GP or make contact with the previous provider, contingent on the patient's consent.

Primary outcomes

  1. number of Emergency Department visits

    Time frame: 12 months after enrollement

Secondary outcomes

  1. total costs of the healthcare resource

    Time frame: 12 months after enrollement

    costs concerning services provided by the University Hospital of Lausanne and cost concerning services used outside the Hospital

Other outcomes

  1. Quality of life

    Time frame: Day of enrollement, 2 months, 5.5 months, 9 months and 12 months

Sponsors and collaborators

Lead sponsor

University of Lausanne

Other

Registry information

Official study title

Case Management for Frequent Users of the Emergency Department: A Randomized Controlled Trial

Important dates

Study start
2012
Primary completion
2014
Study completion
2014
First posted
Sep 4, 2013
Registry last updated
May 27, 2015

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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