Using Case Management in a Universal Health Coverage System to Improve Quality of Life of Frequent Emergency Department Users: a Randomized Controlled Trial

Overview

Journal Qual Life Res

Specialties Pharmacology
Rehabilitation Medicine

Date 2017 Dec 1

PMID 29188481

Citations 9

Authors

Katia Iglesias

Stephanie Baggio

Karine Moschetti

Jean-Blaise Wasserfallen

Olivier Hugli

Jean-Bernard Daeppen

Bernard Burnand

Patrick Bodenmann

Affiliations

Soon will be listed here.

Abstract

Purpose: Frequent Emergency Department users are likely to experience poor quality of life (QOL). Case management interventions are efficient in responding to the complex needs of this population, but their effects on QOL have not been tested yet. Therefore, the aim of our study was to examine to what extent a case management intervention improved frequent Emergency Department users' QOL in a universal health coverage system.

Methods: Data were part of a randomized controlled trial designed to improve frequent Emergency Department users' QOL at the Lausanne University Hospital, Switzerland. A total of 250 frequent Emergency Department users (≥ 5 attendances during the previous 12 months) were randomly assigned to the control (n = 125) or the intervention group (n = 125). The latter benefited from case management intervention. QOL was evaluated using the WHOQOL-BREF at baseline, two, five and a half, nine, and twelve months later. It included four dimensions: physical health, psychological health, social relationship, and environment. Linear mixed-effects models were used to analyze the change in the patients' QOL over time.

Results: Patients' QOL improved significantly (p < 0.001) in both groups for all dimensions after two months. However, environment QOL dimension improved significantly more in the intervention group after 12 months.

Conclusions: Environment QOL dimension was the most responsive dimension for short-term interventions. This may have been due to case management's assistance in obtaining income entitlements, health insurance coverage, stable housing, or finding general health care practitioners. Case management in general should be developed to enhance frequent users' QOL.

Trial Registration: http://www.clinicaltrials.gov , Unique identifier: NCT01934322.

Citing Articles

Experiences of Frequent Users of Emergency Departments in Health Care Setting in French-Speaking Switzerland: A Qualitative Study.

Graells M, Schaad L, Schmutz E, Moullin J, Hugli O, Daeppen J Healthcare (Basel). 2023; 11(9).

PMID: 37174770 PMC: 10178271. DOI: 10.3390/healthcare11091228.

Perspectives of Frequent Users of Emergency Departments on a Case Management Intervention: A Qualitative Study.

Schaad L, Graells M, Kasztura M, Schmutz E, Moullin J, Hugli O Inquiry. 2023; 60:469580231159745.

PMID: 36927138 PMC: 10026145. DOI: 10.1177/00469580231159745.

Optimizing care coordination to address social determinants of health needs for dual-use veterans.

Sjoberg H, Liu W, Rohs C, Ayele R, McCreight M, Mayberry A BMC Health Serv Res. 2022; 22(1):59.

PMID: 35022053 PMC: 8754195. DOI: 10.1186/s12913-021-07408-x.

Does Case Management Provide Support for Staff Facing Frequent Users of Emergency Departments? A Comparative Mixed-Method Evaluation of ED Staff Perception.

von Allmen M, Grazioli V, Kasztura M, Chastonay O, Moullin J, Hugli O BMC Emerg Med. 2021; 21(1):92.

PMID: 34348645 PMC: 8336392. DOI: 10.1186/s12873-021-00481-9.

Qualitative evaluation of primary care providers' experiences caring for frequent users of the emergency department.

Brunner L, Allen M, Malebranche M, Hudon C, Senn N, Hugli O BMJ Open. 2021; 11(6):e044326.

PMID: 34172545 PMC: 8237725. DOI: 10.1136/bmjopen-2020-044326.

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