Case management of patients who frequently present to a Scottish emergency department

To assess whether case management of frequent attenders to the emergency department (ED) reduces subsequent attendances made by these patients.

Patients who attended the ED 10 times or more over a 6-month period were identified. Their cases were assessed and care plans put in place, if appropriate. Patient attendances over the subsequent 6 months were compared.

57 patients attended the ED 10 times or more over the 6-month period (1.4% of the departmental workload). The median number of ED attendances in this patient group was 12.0 (interquartile range (IQR) 10-14). In the subsequent 6 months following case management of these patients, median attendances in the same 57 patients dropped to 6.0 (IQR 2-13, p<0.001). The total number of attendances in this patient group dropped from 720 to 499, a reduction of 31%.

The findings of this study suggest that individual case management and implementation of care plans may help to reduce subsequent attendances in patients who frequently attend ED.