Interdisciplinary Team‐Based Intervention to Reduce Acute Care Utilization Among Emergency Department Multi‐Visit Patients
Yijung K. Kim, Narae Park, Jenna H. Everett, Lauren R. Bangerter, Lucas C. CarlsonABSTRACT
Objective
To evaluate the impact of the emergency department (ED) Multi‐Visit Patient (MVP) Program, a novel team‐based approach to supporting patients with frequent ED utilization.
Study Setting and Design
The ED MVP Program identified patients with frequent ED visits, conducted comprehensive chart reviews, and implemented tailored care plans to address healthcare barriers and social determinants of health. A comparison group included eligible patients who did not receive the intervention as well as those not yet treated at a given month. We conducted a quasi‐experimental study using difference‐in‐differences analysis with dynamic effects.
Data Sources and Analytic Sample
Acute care utilization (ED visits, observation stays, inpatient admissions) and 30‐day readmission data were extracted from the electronic health record system across a multi‐hospital not‐for‐profit healthcare system in the Baltimore–Washington metropolitan area.
Principal Findings
Compared with controls, patients receiving ED MVP intervention had 1.94 fewer acute care hospital visits (95% confidence interval [CI]: −2.54, −1.34) and 2.42 fewer days of acute care utilization (95% CI: −3.19, −1.64) in the following 12 months. There was also a small reduction in 30‐day inpatient readmissions, averaging 0.08 fewer readmissions (95% CI: −0.16, −0.01).
Conclusions
This study provides strong evidence for the effectiveness of a tailored care intervention to reduce acute care utilization among patients with frequent ED utilization.