Hospital-based clinic helped reduce ED super-user visits

A clinic-based multidisciplinary team helped reduce frequent emergency department (ED) user visits at a University of Florida Health hospital in Gainesville, according to research presented at the Society of Teachers in Family Medicine's spring meeting.

After intervention from the Care One Clinic, patients the hospital admitted more than eight times the previous year saw relative risk reductions of 22 percent for ED use, 30 percent for hospitalizations and 24 percent for days spend in the hospital, MedPage Today reported.

Researchers examined the hospital's electronic medical records and found 473 patients accounted for 5,728 ED visits and 2,044 hospitalizations. Of those patients, 147 participated in the study--only 1 percent of whom had private insurance. Clinic staff examined patients, then assigned them a social worker who provided transportation assistance, gave them access to community resources and performed a literacy screening, according to the article.

Patients then met with a doctor, as well as a pain and addiction psychiatrist, and finally with a clinical pharmacist for medication reconciliation, medication compliance assessment and patient education, presenters said.

The Care One Clinic included pain and addiction management and pharmacist-led counseling, and led to a direct cost reduction of $4,000 per patient a year, according to researchers. ED visits fell from 4.9 to 3.8 per Care One patient, hospitalizations dropped from 3 to 2.1 and days spent in the hospital fell from 3.8 to 2.9, compared to the six months before the program, according to MedPageToday.

Many frequent ED users "suffer from addiction, pain, mental illness, homelessness and have a variety of very difficult to treat problems," researcher Deepa Borde, M.D. of the University of Florida, who is also the clinic's director, told MedPage Today. "They need time, and a lot of it is taking the time to delve into those deeper problems, and scheduling these patients properly to take care of them in a more in-depth level."

To learn more:
- read the presentation abstract
- here's the article

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