A case management intervention targeted to reduce healthcare consumption for frequent Emergency Department visitors: results from an adaptive randomized trial.
Setting: Sweden, Hospitals from 3 counties
– Until Death or
– Until End of study (march 2014) or
– Maxi-mum two years.
Total: 12181 (8536)
IG: 8214 (4569)
– site a 7280 (3635)
– site b 934
CG: 3967 (3967)
– site a 3508
– site b 459
3 or more emergency visits during previous 6 months.
– Coaching disease self-management
– Support interaction with social services
– Facilitated contacts with healthcare providers.
Patient and nurse meet for interview of patient’s medical and social history. This information was used to guide the intervention. Telephone contact was made on a regular basis. Nurses facilitated contacts with healthcare providers, coached patients’ disease self-management, and supported interactions with social services.
Duration: max 2 years
Add on: +
– Risk of hospitalization:
Site a →
Site b ↓
– Nurses were employed by a private entity (Health navigator.)
– Training nurses
– Nurses for interview and telephone call
– Development of new skills (nurses)
Health care utilization:
Total healthcare costs →
Number of days in hospital →