Interdisciplinary Team-Based Intervention to Reduce Acute Care Utilization Among Emergency Department Multi-Visit Patients.

Abstract

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.