Early intervention can help stem the tide of ER 'super-users'

Frequent visitors to hospital emergency rooms account for disproportionate amounts of healthcare spending and take up precious resources in already overextended emergency healthcare facilities. 

But a coordinated effort by hospital staff and the community in the state of Maryland has reduced the number of ER visits by these patients and could provide a model for other healthcare facilities around the country, The Baltimore Sun reported.

"Super-users" often lack social and other resources necessary to get routine medical care and end up making frequent use of ambulances and ERs when their level of acuity becomes urgent. To combat the problem, Baltimore's Sinai Hospital implemented an early intervention program and flags patients who visited the ER more than four timers per month. Care coordinators then connect the patients to primary care doctors and low-cost insurance. 

Care coordinators not only help patients make appointments with physicians, but they arrange transportation to get them there. They also help patients get food aid and assistance to pay for power and heating costs.

Danielle Richards, one of three care coordinators at Sinai Hospital, told the publication that 90 percent of the patients targeted for these interventions have made progress since the program began. The 10 percent who have not, she said, are generally people with serious behavioral issues.

Rachel Davis, a senior program officer at the Center for Health Care Strategies, told the newspaper that hospitals across the state adopt similar programs. For example, case workers at University of Maryland Medical Center can get patients help with mental health and substance abuse issues, connect them to low-income housing programs and otherwise improve their quality of life so that they do not find themselves back in the loop of endless ER visits or getting shunted from one inadequate care setting to another.

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