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Care plans reduce ED visits in those with drug-seeking behavior
Frederick Fiesseler1, Renee Riggs2, David Salo1
1Morristown Medical Center, Department of Emergency Medicine, Morristown, NJ.
Unlabelled:
Patients with drug-seeking behavior can be both labor and resource intensive to the emergency department (ED).
Objective:
To determine the effectiveness of ED care plans for individuals at high risk for drug-seeking behavior on ED visits.
Methods:
A retrospective, cohort observational study.
Location:
A suburban teaching hospital with an annual census of 80,000 patients. The number of ED visits was determined 1 year before and 2 subsequent years following care plan initiation.
Exclusion Criteria:
Unclaimed letter, incomplete data, and/or non-drug-seeking care plan.
Statistics:
Two-tailed Wilcoxon signed-rank test with significance of P < .05.
Results:
Sixty patients were enrolled and 7 were excluded, leaving 53 patients for analysis. Mean annual visits before care plan initiation were 7.6 (95% confidence interval [CI], 6.3-9.1). One year following implementation, mean visits decreased to 2.3 (95% CI, 1.5-3.1) (P ≤ .0001). Two years following implementation, mean visits continued to decline to 1.5 (95% CI, 0.9-2.1) (P ≤ .0001). A significant reduction in visits occurred 1 and 2 years following care plan implementation.
Conclusions:
Emergency department care plans are an effective method to reduce ED visits in those with drug-seeking behavior.
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