Table 3

Effect of ED-based specialised models of care on practice delivery and costs

StudyInterventionComparisonSample sizeAge (years) (mean (SD))OutcomeMeasure of effectEffect (intervention vs comparison)
Grover and Lee29 Behavioural health unitStandard ED roomI: 2475
C: 2168
I: 13.2 (3.28)
C: 13.6 (3.14)
Length of stayAbsolute difference−45 min
Security man-hours per 100 patientsMean difference−36.8 hours (95% CI −48.3 to −25.3)
Restraint orders per 100 patientsMean difference−0.9 orders (95% CI −1.64 to −0.16)
Mahajan
et al 30
Child guidance modelStandard ED careI: 561
C: 470
12.5 (3.4)Length of stayMean difference−43.1 min (95% CI −63.1 to −23.1)
Cost of ED careCost per patient per hourUS$18.98
Parker et al 26 Rapid response modelStandard ED careNTDNTDMonthly admissions to inpatient psychiatry resultant from RRM consultationMean differences*First RRM vs pre-RRM: −0.3
RRM termination vs first RRM: 1.2
Second RRM vs RRM termination: −4.9
Greenfield
et al 31
Emergency room follow-up teamStandard ED careI: 568
C: 412
14.6 (1.5)Number of hospitalisations† over a 1-year periodRelative risk0.56 (95% CI 0.46 to 0.69)
Risk difference− 16.1% (95% CI − 21.8%  to − 10.4%)
Number needed to treat7
Number of ED return 
visits over a 1- year period
Relative risk0.61 (95% CI 0.32  to 1.17)
  • *Unable to calculate 95% CIs due to unknown sample size; using study-reported data to clarify the findings, we are confident of a statistically significant difference for the last comparison (second RRM vs RRM termination), but not clear about whether there are significant differences for the first two comparisons.

  • †Medical or psychiatric hospitalisation.

  • CI, Confidence interval; NTD, not able to determine; RRM, rapid response model.