A case management intervention targeted to reduce healthcare consumption for frequent Emergency Department visitors: results from an adaptive randomized trial.

Source: Edgren, G., et al. 2016 - Pubmed ID: 25969342

Setting: Sweden, Hospitals from 3 counties

Study design:



Follow up:

  • Until Death or
  • Until End of study (march 2014) or
  • Maximum two years
Patient group:

Sample size:

Total: 12181 (8536)

IG: 8214 (4569)

CG: 3967 (3967)


Inclusion criteria:

  • 3 or more emergency visits during previous 6 months.
Type of technology:

Phone call

  • Coaching disease self-management
  • Support interaction with social services
  • Facilitated contacts with healthcare providers.

Intervention: 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: +


Control group: No intervention

Clinical effect/ Patient safety:

Clinical effect:

  • Risk of hospitalization: Site a → / Site b ↓


Patient safety: NA

Patient experiences/ Staff experiences:

Patient experiences: NA


Staff experiences: NA

Costs and organization:

Staff resources

  • Nurses were employed by a private entity (Health navigator.)
  • Training nurses


Staff resources

  • Nurses for interview and telephone call


  • Development of new skills (nurses)


Health care utilization:

  • Total healthcare costs →
  • Number of days in hospital →
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“↑”: Statistically significant increase

“↓”: Statistically significant decrease

“→”: Statistically insignificant (no difference)