Coordination Program Reduced Acute Care Use And Increased Primary Care Visits Among Frequent Emergency Care Users

Area of Science:

• Health Services Research
• Public Health
• Healthcare Management

Background:

• High emergency department (ED) utilization is common among patients with public insurance, particularly Medicaid beneficiaries.
• Identifying effective interventions to manage this population is crucial for healthcare systems.

Purpose of the Study:

• To evaluate the impact of the Bridges to Care (B2C) program on ED use, hospital admissions, and primary care utilization.
• To assess the effectiveness of an ED-initiated, multidisciplinary, community-based program for publicly insured high ED utilizers.

Main Methods:

• A quasi-experimental study design comparing outcomes between B2C participants and a control group.
• Data collection focused on ED visits, hospital admissions, and primary care visits during the six months post-intervention.
• Subanalysis included patients with mental health comorbidities.

Main Results:

• B2C participants showed a 27.9% reduction in ED visits and a 114.0% increase in primary care visits compared to controls.
• In patients with mental health comorbidities, B2C led to a 29.7% decrease in ED visits, a 30.0% decrease in hospitalizations, and a 123.2% increase in primary care visits.

Conclusions:

• The B2C program effectively reduced acute care utilization (ED visits and hospitalizations) among high ED utilizers with public insurance.
• The intervention significantly increased primary care visits, indicating a successful shift in care management for this population, including those with mental health needs.