TY - JOUR
T1 - A pilot mobile integrated healthcare program for frequent utilizers of emergency department services
AU - Nejtek, Vicki Allene
AU - Aryal, Subhash
AU - Talari, Deepika
AU - Wang, Hao
AU - O'Neill, Liam
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Purpose To examine whether or not a mobile integrated health (MIH) program may improve health-related quality of life while reducing emergency department (ED) transports, ED admissions, and inpatient hospital admissions in frequent utilizers of ED services. Methods A small retrospective evaluation assessing pre- and post-program quality of life, ED transports, ED admissions, and inpatient hospital admissions was conducted in patients who frequently used the ED for non-emergent or emergent/primary care treatable conditions. Results Pre- and post-program data available on 64 program completers are reported. Of those with mobility problems (n = 42), 38% improved; those with problems performing usual activities (N = 45), 58% reported improvement; and of those experiencing moderate to extreme pain or discomfort (N = 48), 42% reported no pain or discomfort after program completion. Frequency of ED transports decreased (5.34 ± 6.0 vs. 2.08 ± 3.3; p < 0.000), as did ED admissions (9.66 ± 10.2 vs. 3.30 ± 4.6; p < 0.000), and inpatient hospital admissions (3.11 ± 5.5 vs. 1.38 ± 2.5; p = 0.003). Conclusion Results suggest that MIH participation is associated with improved quality of life, reduced ED transports, ED admissions, and inpatient hospital admissions. The MIH program may have potential to improve health outcomes in patients who are frequent ED users for non-emergent or emergent/primary care treatable conditions by teaching them how to proactively manage their health and adhere to therapeutic regimens. Programmatic reasons for these improvements may include psychosocial bonding with participants who received in-home care, health coaching, and the MIH team's 24/7 availability that provided immediate healthcare access.
AB - Purpose To examine whether or not a mobile integrated health (MIH) program may improve health-related quality of life while reducing emergency department (ED) transports, ED admissions, and inpatient hospital admissions in frequent utilizers of ED services. Methods A small retrospective evaluation assessing pre- and post-program quality of life, ED transports, ED admissions, and inpatient hospital admissions was conducted in patients who frequently used the ED for non-emergent or emergent/primary care treatable conditions. Results Pre- and post-program data available on 64 program completers are reported. Of those with mobility problems (n = 42), 38% improved; those with problems performing usual activities (N = 45), 58% reported improvement; and of those experiencing moderate to extreme pain or discomfort (N = 48), 42% reported no pain or discomfort after program completion. Frequency of ED transports decreased (5.34 ± 6.0 vs. 2.08 ± 3.3; p < 0.000), as did ED admissions (9.66 ± 10.2 vs. 3.30 ± 4.6; p < 0.000), and inpatient hospital admissions (3.11 ± 5.5 vs. 1.38 ± 2.5; p = 0.003). Conclusion Results suggest that MIH participation is associated with improved quality of life, reduced ED transports, ED admissions, and inpatient hospital admissions. The MIH program may have potential to improve health outcomes in patients who are frequent ED users for non-emergent or emergent/primary care treatable conditions by teaching them how to proactively manage their health and adhere to therapeutic regimens. Programmatic reasons for these improvements may include psychosocial bonding with participants who received in-home care, health coaching, and the MIH team's 24/7 availability that provided immediate healthcare access.
KW - Emergency medicine
KW - Emergency utilization
KW - Mobile integrated healthcare
UR - http://www.scopus.com/inward/record.url?scp=85018442365&partnerID=8YFLogxK
U2 - 10.1016/j.ajem.2017.04.061
DO - 10.1016/j.ajem.2017.04.061
M3 - Article
C2 - 28495031
AN - SCOPUS:85018442365
SN - 0735-6757
VL - 35
SP - 1702
EP - 1705
JO - American Journal of Emergency Medicine
JF - American Journal of Emergency Medicine
IS - 11
ER -