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Implementation of a Real-Time Psychosis Risk Detection and Alerting System Based on Electronic Health Records using CogStack
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Predictive Model-Driven Hotspotting to Decrease Emergency Department Visits: a Randomized Controlled Trial.

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  • 1Northeastern University Bouvè College of Health Sciences, Boston, MA, USA.

Journal of General Internal Medicine
|March 11, 2021
PubMed
Summary
This summary is machine-generated.

A community case management program did not significantly reduce emergency department (ED) visits for complex patients. Further research should explore enhanced patient engagement and longer evaluation periods for case management interventions.

Keywords:
Prior Presentations: Nonecase managementemergency departmentpatientutilization

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Area of Science:

  • Health Services Research
  • Public Health
  • Healthcare Management

Background:

  • Emergency department (ED) visits represent a significant healthcare expenditure.
  • Case management is a proposed strategy for addressing complex patients' medical and social needs.
  • Limited research designs exist to evaluate the effectiveness of case management interventions.

Purpose of the Study:

  • To evaluate if a community-based case management program reduced ED utilization among complex patients.
  • Assessed the association between case management and healthcare resource utilization.
  • Investigated the impact on both ED and other healthcare visits.

Main Methods:

  • Randomized controlled trial design involving complex patients identified by risk threshold.
  • Intervention group offered coordinated case management; control group received usual care.
  • Intention-to-treat and local average treatment effect analyses adjusted for baseline characteristics.

Main Results:

  • The community case management intervention was not significantly associated with reduced ED visits (intention-to-treat effect: +0.14).
  • The local average treatment effect also showed no significant reduction in ED visits (+0.53).
  • Secondary outcomes, including inpatient and outpatient visits, were not significantly affected.

Conclusions:

  • The evaluated community case management program did not reduce ED utilization.
  • Future interventions may require enhanced patient engagement strategies.
  • Longer evaluation periods could provide further insights into program effectiveness.