Case management of patients who frequently present to a Scottish emergency department

Aims: To assess whether case management of frequent attenders to the emergency department (ED) reduces subsequent attendances made by these patients.

Methods: Patients who attended the ED 10 times or more over a 6-month period were identified. Their cases were assessed and care plans put in place, if appropriate. Patient attendances over the subsequent 6 months were compared.

Results: 57 patients attended the ED 10 times or more over the 6-month period (1.4% of the departmental workload). The median number of ED attendances in this patient group was 12.0 (interquartile range (IQR) 10-14). In the subsequent 6 months following case management of these patients, median attendances in the same 57 patients dropped to 6.0 (IQR 2-13, p <0.001). The total number of attendances in this patient group dropped from 720 to 499, a reduction of 31%.

Conclusions: The findings of this study suggest that individual case management and implementation of care plans may help to reduce subsequent attendances in patients who frequently attend ED.