Personalized Care Plans: Are They Effective in Decreasing ED Visits and Health Care Expenditure Among Adult Super-Utilizers?

Journal Article (Journal Article)

PROBLEM:Super-utilizers comprise 4.5% to 8% of all ED patients, but account for 21% to 28% of all ED visits. Excessive use of the emergency department contributes to increased health care costs, recurrent and unnecessary ED workup, decreased emergency readiness, and reduced staff morale. METHODS:The impact of personalized care plan implementation was evaluated using a within-subjects pre-post design. The number of ED visits for each enrolled patient (N = 65) were analyzed before and after personalized care plan enrollment at 90, 180, and 365 days. A post-hoc analysis was completed for each ED visit that resulted in a disposition of discharge. Total and average charges from the ED visits were analyzed to determine the intervention's effect on health care expenditure. Staff was anonymously surveyed to assess perceived efficacy and level of satisfaction with the intervention before completion of data collection. RESULTS:Median ED visits had a statistically significant decrease over 90, 180, and 365 days. There was also a decrease in median, average, and total ED charges for all time points. ED staff perceived the personalized care plans to be an effective intervention and were satisfied with their implementation. DISCUSSION:Personalized care plans effectively decreased the number of ED visits, reduced health care expenditure, and were well-received by the staff.

Full Text

Duke Authors

Cited Authors

  • Bergenstal, TD; Reitsema, J; Heppner, P; Geerts, J; Cho, A; Smallheer, B

Published Date

  • January 2020

Published In

Volume / Issue

  • 46 / 1

Start / End Page

  • 83 - 90

PubMed ID

  • 31685338

Electronic International Standard Serial Number (EISSN)

  • 1527-2966

International Standard Serial Number (ISSN)

  • 0099-1767

Digital Object Identifier (DOI)

  • 10.1016/j.jen.2019.09.001


  • eng