Table 3 Summary of Interventions and Outcomes

Case management/ care coordination/ acute care plans

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

Financial assistance (social security)

X

Goal setting

X

Group therapy

X

X

X

Harm reduction services

X

Housing

X

X

X

Individual visits / CHW/ Nurse

X

X

X

X

X

X

X

X

Mentoring

X

Monetary assistance with pharmacy, lab tests and other medical costs

X

Multidisciplinary

X

X

X

X

X

X

Problem solving

X

Referral to specialists and other services including social services

X

X

X

X

X

X

X

X

X

X

X

Telephone

X

X

X

X

X

X

X

X

X

Transportation

X

X

Change in ED use

↓

↓

Mixed

↓

↓

↓

↓

↓

↓

↓

↓

↓

↓

↓ ED use but not in inpatient

↓

↓

Magnitude of change

ED use dropped from a rate of 0.58 per patient per month to 0.23**

Fewer ED visits, 0.93 vs 1.44**

12% decrease in hospitalisation (95%CI 4–19%)

V

30 ED presentations by 11 users in 2006 dropped to 22 presentations by 9 users in 2009.

830 fewer ED visits and a 49.26% change**

Mean difference of 5.5 and a 37.4% change**

35% fewer ED visits

frequent users decreased by 5 visits (95% CI of 2–5); extreme users decreased by 15 visits (95% CI of 13–17)*

ED visits decreased by 178/1000 visits; hospital admission by 53/1000 visits*

Median number of visits decreased from 15 to 9 visits (95% CI of 3–7 visits)**

RR 0.77 (95% CI of 0.69–0.86)

13.2% decrease in ED use from 1148 to 996 visits**

V

Visits decreased by 25% from 67.4 to 50.5 (95% CI 0.3 to 33)*

Visits decreased by 28.1% from 199 to 143**

Change in cost

↓

↓

Mixed

↓

↑ outpatient clinic use. ↓ crisis ED use.

↓

↓

↓

↓

↓

↓

↓

↓

Effective but not cost saving

↓

↓

Magnitude of change

Hospital charges dropped from $1167 per patient per month to $230**

$1188 vs $446**

V

V

NR

$2,785,690 absolute change and 47.81% change**

Mean difference of $6290 and 47.9%**

ED costs were 15% lower

Decrease in frequent ED use by $1285 (95% CI of $492–$2364); extreme ED use decreased by $6091 (95% CI of $4298–$8998)*

A saving of $21 per member per month for ED visits or $59 per member per month on admissions.

ED costs decreased from $4124 to $2192 (95% CI $1013 to $2459 to); and inpatient costs decreased from $8330 to $2786 (95% CI $0 to $8330).**

45% decrease in total cost per patient**

26.6% decrease (95% CI 26.1 to 27%)**

V

decreased by 24% from $64,721 to $49,208 (95% CI $83 to -$30,943)*

12.7% decrease in costs from $413,410 to $360,779