Emergency departments: reducing use by frequent attenders

Added June 23, 2020

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.


Disclaimer: This summary has been written by staff and volunteers of Evidence Aid in order to make the content of the original document accessible to decision makers who are searching for the available evidence on the coronavirus (COVID-19) but may not have the time, initially, to read the original report in full. This summary is not intended as a substitute for the medical advice of physicians, other health workers, professional associations, guideline developers, or national governments and international agencies. If readers of this summary think that the evidence that is presented within it is relevant to their decision-making they should refer to the content and details of the original article, and the advice and guidelines offered by other sources of expertise, before making decisions. Evidence Aid cannot be held responsible for any decisions made about the coronavirus (COVID-19) on the basis of this summary alone.