Interdisciplinary Team‐Based Intervention to Reduce Acute Care Utilization Among Emergency Department Multi‐Visit Patients
研究评估了急诊科多次就诊患者项目，通过团队制定个性化护理计划，使患者12个月内急性护理就诊次数减少1.94次，住院天数减少2.42天。
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.