Case Management Reduces Length of Stay, Charges, and Testing in Emergency Department Frequent Users

Area of Science:

• Healthcare Management
• Health Services Research
• Patient Outcomes

Background:

• Frequent emergency department (ED) users incur significant healthcare costs and resource utilization.
• Case management programs offer a structured approach to support high-need patients.
• Short-term case management aims to mitigate ED overuse and associated expenses.

Purpose of the Study:

• To evaluate the effectiveness of a case management program for frequent ED users.
• To assess the impact on ED visits, hospital admissions, length of stay (LOS), diagnostic test utilization, and costs.

Main Methods:

• Retrospective chart review of 158 patients enrolled in an ED case management program.
• Comparison of patient utilization and costs in the year prior to and the year after program enrollment.
• Analysis included ED visits, inpatient admissions, LOS, diagnostic imaging (CT, ultrasound, radiographs), and incurred charges.

Main Results:

• A 49% decrease in ED visits and a 39% reduction in inpatient admissions were observed post-enrollment.
• Utilization of CT imaging decreased by 41%, ultrasound by 52%, and radiographs by 38%.
• Total LOS decreased by 178 days (39% reduction), and healthcare charges fell by $5.8 million (41% reduction).

Conclusions:

• ED case management is a highly effective strategy for reducing patient visits and resource consumption.
• The program demonstrates significant cost savings and improved efficiency in healthcare delivery for frequent ED users.
• Implementing case management can lead to substantial reductions in diagnostic testing and length of stay.