Case management of patients who frequently present to a Scottish emergency department
- 1Emergency Department, Royal Infirmary Edinburgh, Edinburgh, UK
- 2Department of Liaison Psychiatry, Royal Infirmary Edinburgh, Edinburgh, UK
- Dr J Skinner, Emergency Department, Royal Infirmary Edinburgh, 51 Little France Crescent, Edinburgh EH16 5SA, UK; janet.skinner{at}luht.scot.nhs.uk
- Accepted 1 July 2008
Abstract
Aims: To assess whether case management of frequent attenders to the emergency department (ED) reduces subsequent attendances made by these patients.
Methods: Patients who attended the ED 10 times or more over a 6-month period were identified. Their cases were assessed and care plans put in place, if appropriate. Patient attendances over the subsequent 6 months were compared.
Results: 57 patients attended the ED 10 times or more over the 6-month period (1.4% of the departmental workload). The median number of ED attendances in this patient group was 12.0 (interquartile range (IQR) 10–14). In the subsequent 6 months following case management of these patients, median attendances in the same 57 patients dropped to 6.0 (IQR 2–13, p<0.001). The total number of attendances in this patient group dropped from 720 to 499, a reduction of 31%.
Conclusions: The findings of this study suggest that individual case management and implementation of care plans may help to reduce subsequent attendances in patients who frequently attend ED.
Footnotes
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Competing interests: None.
