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CONECT-6: a case-finding tool to identify patients with complex health needs.

Catherine Hudon1, Mathieu Bisson2, Marie-France Dubois2

  • 1Department of Family Medicine and Emergency Medicine, University of Sherbrooke, 3001 12e Avenue N, Sherbrooke, QC, J1H 5H3, Canada. Catherine.Hudon@usherbrooke.ca.

BMC Health Services Research
|February 18, 2021
PubMed
Summary

A new six-question tool, CONECT-6, effectively identifies adult patients with chronic conditions and complex needs in emergency departments. This tool aids case management and reduces healthcare costs by enabling early intervention.

Keywords:
Ambulatory care sensitive conditionCase managementCase-finding toolChronic diseasesComplexityFrequent user

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Area of Science:

  • Healthcare Management
  • Clinical Informatics
  • Public Health

Background:

  • Emergency departments (EDs) can improve care for patients with chronic conditions and complex needs through early identification and case management.
  • A dedicated case-finding tool can support ED teams and reduce costs associated with avoidable ED visits and hospitalizations.

Purpose of the Study:

  • To develop and validate a concise, self-administered case-finding tool for identifying adult patients with chronic conditions and complex health needs within ED settings.

Main Methods:

  • A prospective study in four Quebec EDs involved adult patients with chronic conditions visiting EDs 3+ times in 12 months.
  • A 12-question self-administered questionnaire was developed, including socio-demographics, comorbidity index, and the INTERMED self-assessment.
  • Multivariate logistic regression and ROC curve analysis were used to refine the tool and determine an optimal threshold.

Main Results:

  • The final tool, COmplex NEeds Case-finding Tool - 6 (CONECT-6), comprises six questions assessing perceived health, pain, unmet needs, complexity, income, and social support.
  • With a threshold of two or more positive answers, CONECT-6 demonstrated 90% sensitivity and 66% specificity.
  • Positive and negative predictive values were 49% and 75%, respectively.

Conclusions:

  • Case-finding is crucial for effective case management.
  • CONECT-6 is the first validated tool designed to identify adult patients with chronic conditions and complex needs in the ED setting.