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Case management in emergency care: impact evaluation of the CARED Program
Colin Eng Choon Ong1, Joanne Yan Ting Yap2, Kamala Velu1
1Department of Emergency Medicine, Ng Teng Fong General Hospital, 1 Jurong East Street 21, Singapore 609606, Singapore.
Summary
The Case management for At-Risk patients in the Emergency Department (CARED) program significantly reduced hospital readmissions and emergency department visits for at-risk patients. This transitional care strategy also lowered healthcare costs and hospital bed occupancy.
Area of Science:
- Geriatric Medicine
- Health Services Research
- Emergency Medicine
Background:
- Hospitals face increasing pressure to reduce unplanned utilization due to an aging population.
- The Case management for At-Risk patients in the Emergency Department (CARED) program targets frail older adults and ED re-attenders.
- CARED is an innovative transitional care strategy designed to decrease acute hospital use.
Purpose of the Study:
- To evaluate the CARED program's effectiveness in reducing hospital readmissions and ED re-attendances.
- To assess the impact of CARED on healthcare costs and hospital bed occupancy.
Main Methods:
- A retrospective, propensity-matched study was conducted from April 2022 to July 2023.
- The CARED program involved geriatric assessment, multidisciplinary care, discharge planning, and community-based service referrals.
- Primary outcomes included 30- and 60-day hospital (re)admissions and ED re-attendances.
Main Results:
- Propensity score matching created comparable intervention and control groups (1615 patients each).
- The CARED program significantly reduced 30- and 60-day hospital admissions and ED re-attendances.
- Significant cost avoidance in inpatient admissions and ED attendances, along with reduced bed occupancy days, was observed.
Conclusions:
- The CARED program effectively reduces unplanned hospital use in at-risk patients post-discharge.
- CARED demonstrates potential for improving patient outcomes and decreasing healthcare expenditures.
- This transitional care model offers a valuable approach to managing healthcare demand and resource utilization.
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