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Evaluation of a Case-management Program for Frequent Emergency Department Users (DAUM)

3 giugno 2026 aggiornato da: CHOUIHED Tahar, Central Hospital, Nancy, France

The DAUM Case-management Program for Frequent Users of the Nancy University Hospital Emergency Department: Evaluation Protocol

The DAUM case-management program for frequent users (FUs) of emergency department was developed to improve FUs identification and management. FUs were eligible if they had four ED visits or more in the previous year, and attended the ED between November, 2022 and October, 2023. Patients were identified in the ED and addressed to the territorial support platform. A personalized health coordination plan which included a care plan (care objectives) and a support plan (social objectives) was co-constructed by the support platform, the patient, their caregiver(s), and their GP. Follow-up assessments at three to six months and at one year evaluated whether individual objectives were achieved. The primary outcomes were participants' mean number of ED visits during their year of participation in the program compared to the previous year, and the incremental cost-effectiveness ratio (ICER), expressed as the cost per ED visit avoided. Secondary outcomes included reach, adoption, implementation, and maintenance indicators.

Panoramica dello studio

Stato

Completato

Condizioni

Intervento / Trattamento

Tipo di studio

Interventistico

Iscrizione (Effettivo)

153

Fase

  • Non applicabile

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

  • Francia
      • Nancy, Francia
        • Nancy University Hospital

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

  • Adulto
  • Adulto più anziano

Accetta volontari sani

No

Descrizione

Inclusion Criteria:

  • adults
  • who visited the ED of Nancy University Hospital between November 7th, 2022, and October 6th, 2023
  • with at least four ED visits during the preceding year
  • residing in Nancy or the surrounding urban areas

Exclusion Criteria:

  • homeless patients
  • patient refusal to participate
  • patient's GP refusal to participate

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Ricerca sui servizi sanitari
  • Assegnazione: N / A
  • Modello interventistico: Assegnazione di gruppo singolo
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Case-management program
Patients included in the case-management program
Comportamentale: Case-management program

FUs patients were identified by the admission nurse through an alert generated by the ED information system. The ED physician explained the DAUM program to the patient and notified the Territorial Support Platform (TSP). The TSP team contacted the patient and his/her GP to present the DAUM program, obtain their agreement to participate and collect additional information.

Once the patient included in the DAUM program, a Personalized Health Coordination Plan (PHCP) was co-constructed by the TSP team, in collaboration with the patient, hi/her GP, and other caregiver(s). The PHCP is divided into a care plan (with care objectives) and a support plan (with social obectives). Once the objectives of the care and support plans were identified for a patient, specific actions and timeframes were established for each objective. Follow-up assessments were conducted at three to six months from the inclusion and at one year.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Effectiveness
Lasso di tempo: Before-after comparison between the mean number of ED visits during the year of program participation and the mean number of ED visits in the preceding year
Mean number of ED visits among included patients
Before-after comparison between the mean number of ED visits during the year of program participation and the mean number of ED visits in the preceding year
Cost-effectiveness
Lasso di tempo: One year
Incremental cost-effectiveness ratio in cost per ED visit avoided
One year

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Indicator Reach 1 - Percentage of patients who consented to participate in the DAUM program among eligible patients
Lasso di tempo: One year
[number of patients who consented to participate in the DAUM program / number of eligible patients] x 100
One year
Indicator Reach 2 - Percentage of patients who consented to participate in the program among patients to whom the program was proposed
Lasso di tempo: One year
[number of patients who consented to participate in the DAUM program / number of patients to whom the DAUM program was proposed] x 100
One year
Indicator Reach 3 - Percentage of patients who effectively participated in the program
Lasso di tempo: One year
[number of patients who effectively participated in the DAUM program (PHCP validated) / number of included patients] x 100
One year
Indicator Adoption 1 - Percentage of patients notified to the TSP by ED physicians
Lasso di tempo: One year
[number of patients notified to the TSP by ED physicians / number of potentially eligible patients (i.e., patients identified as FU who visited the ED during the study period)] x 100
One year
Indicator Adoption 2 - Percentage of patients who had been informed about the program during their ED visit
Lasso di tempo: One year
[number of patients who had been informed about the DAUM program during their ED visit / number of patients to whom the DAUM program was proposed by the TSP] x 100
One year
Indicator Implementation 1 - Percentage of patients notified to the TSP by ED physicians within three days of their ED visit
Lasso di tempo: One year
[number of patients notified to the TSP by ED physicians within three days of their ED visit / number of patients notified to the TSP by ED physicians] x 100
One year
Indicator Implementation 2 - Percentage of patients whose GP was contacted within 48 hours of the notification by an ED physician
Lasso di tempo: One year
[number of patients whose GP was contacted within 48 hours of the notification by an ED physician / number of eligible patients] x 100
One year
Indicator Implementation 3 - Percentage of patients contacted by the TSP team within seven days of the notification by an ED physician
Lasso di tempo: One year
[number of patients contacted by the TSP team within seven days of the notification by an ED physician / number of patients to whom the DAUM program was proposed] x 100
One year
Indicator Implementation 4 - Percentage of patients for whom a PHCP was validated within a month of the first contact between the TSP team and the patient
Lasso di tempo: One year
[number of patients for whom a PHCP was validated within a month of the first contact (between the TSP team and the patient) / number of patients who had a PHCP] x 100
One year
Indicator Implementation 5 - Percentage of patients who benefited from the first actions of the PHCP within two weeks of the PHCP validation
Lasso di tempo: One year
[number of patients who benefited from the first actions of the PHCP within two weeks of the PHCP validation / number of patients who had a PHCP validated] x 100
One year
Indicator Implementation 6 - Percentage of patients with a 3- to 6-month assessment
Lasso di tempo: 3 and 6 months
[number of patients with a 3-to 6-month assessment / number of patients who had a PHCP validated] x 100
3 and 6 months
Indicator Implementation 7 - Percentage of patients with a 1-year assessment
Lasso di tempo: One year
[number of patients with a 1-year assessment / number of patients not dead or lost to follow-up during the year] x 100
One year
Indicator Implementation 8 - Percentage of patients for whom all the PHCP actions were implemented as planned at the 1-year assessment
Lasso di tempo: One year
[number of patients for whom all the PHCP actions were implemented as planned at the 1-year assessment / number of patients followed-up at 1 year] x 100
One year
Indicator Maintenance R1 - Percentage of patients who consented to participate in the DAUM program among eligible patients
Lasso di tempo: One year
[number of patients who consented to participate in the DAUM program / number of eligible patients] x 100, calculated each month
One year
Indicator Maintenance R2 - Percentage of patients who consented to participate in the program among patients to whom the program was proposed
Lasso di tempo: One year
[number of patients who consented to participate in the DAUM program / number of patients to whom the DAUM program was proposed] x 100, calculated each month
One year
Indicator Maintenance R3 - Percentage of patients who effectively participated in the program
Lasso di tempo: One year
[number of patients who effectively participated in the DAUM program (PHCP validated) / number of included patients] x 100, calculated each month
One year
Indicator Maintenance A1 - Percentage of patients notified to the TSP by ED physicians
Lasso di tempo: One year
[number of patients notified to the TSP by ED physicians / number of potentially eligible patients (i.e., patients identified as FU who visited the ED during the study period)] x 100, calculated each month
One year
Indicator Maintenance A2 - Percentage of patients who had been informed about the program during their ED visit
Lasso di tempo: One year
[number of patients who had been informed about the DAUM program during their ED visit / number of patients to whom the DAUM program was proposed by the TSP] x 100, calculated each month
One year
Indicator Maintenance I1 - Percentage of patients notified to the TSP by ED physicians within three days of their ED visit
Lasso di tempo: One year
[number of patients notified to the TSP by ED physicians within three days of their ED visit / number of patients notified to the TSP by ED physicians] x 100, calculated each month
One year
Indicator Maintenance I2 - Percentage of patients whose GP was contacted within 48 hours of the notification by an ED physician
Lasso di tempo: One year
[number of patients whose GP was contacted within 48 hours of the notification by an ED physician / number of eligible patients] x 100, calculated each month
One year
Indicator Maintenance I3 - Percentage of patients contacted by the TSP team within seven days of the notification by an ED physician
Lasso di tempo: One year
[number of patients contacted by the TSP team within seven days of the notification by an ED physician / number of patients to whom the DAUM program was proposed] x 100, calculated each month
One year
Indicator Maintenance I4 - Percentage of patients for whom a PHCP was validated within a month of the first contact between the TSP team and the patient
Lasso di tempo: One year
[number of patients for whom a PHCP was validated within a month of the first contact (between the TSP team and the patient) / number of patients who had a PHCP] x 100, calculated each month
One year
Indicator Maintenance I5 - Percentage of patients who benefited from the first actions of the PHCP within two weeks of the PHCP validation
Lasso di tempo: One year
[number of patients who benefited from the first actions of the PHCP within two weeks of the PHCP validation / number of patients who had a PHCP validated] x 100, calculated each month
One year
Indicator Maintenance I6 - Percentage of patients with a 3- to 6-month assessment
Lasso di tempo: One year
[number of patients with a 3-to 6-month assessment / number of patients who had a PHCP validated] x 100, calculated each month
One year
Indicator Maintenance I7 - Percentage of patients with a 1-year assessment
Lasso di tempo: One year
[number of patients with a 1-year assessment / number of patients not dead or lost to follow-up during the year] x 100, calculated each month
One year

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Central Hospital, Nancy, France

Collaboratori

agence régionale de santé Grand Est
Dispositif d'appui à la coordination de Meurthe-et-Moselle

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Pubblicazioni generali

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

7 novembre 2022

Completamento primario (Effettivo)

31 ottobre 2024

Completamento dello studio (Effettivo)

31 ottobre 2024

Date di iscrizione allo studio

Primo inviato

19 maggio 2026

Primo inviato che soddisfa i criteri di controllo qualità

3 giugno 2026

Primo Inserito (Effettivo)

9 giugno 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

9 giugno 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

3 giugno 2026

Ultimo verificato

1 giugno 2026

Maggiori informazioni

Termini relativi a questo studio

Parole chiave

Termini MeSH pertinenti aggiuntivi

Altri numeri di identificazione dello studio

  • 2022_PI_095

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

NO

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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