Emergency departments: reducing use by frequent attenders
Citation: Soril LJ, Leggett LE, Lorenzetti DL, et al. Reducing frequent visits to the emergency department: a systematic review of interventions. PloS one. 2015;10(4): e0123660.
What is this? The COVID-19 pandemic is placing a strain on healthcare services. Existing research on the effects of interventions to reduce emergency department use might provide useful information for policy makers.
In this systematic review, the authors searched for articles of the effects and cost impact of interventions aimed at reducing the use of emergency departments by adults who frequently use emergency departments. They restricted their searches to articles published in English and did the search in January 2015. They included 4 randomized trials and 13 non-randomized comparative cohort studies, which were from Australia and New Zealand (3 studies), Canada (1), Scotland (1), Sweden (2), Taiwan (1) and the USA (9)
What works: Case management had the most rigorous evidence base, and yielded moderate cost savings, but with variable reductions in emergency department use by adults who frequently used emergency departments.
What doesn’t work: Individualized care plans and information sharing interventions did not significantly reduce the number of emergency department visits by adults who frequently used emergency departments.
What’s uncertain: The most clinically beneficial and cost-effective interventions to deter frequent emergency department use by adults are uncertain.
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