Deze pagina is automatisch vertaald en de nauwkeurigheid van de vertaling kan niet worden gegarandeerd. Raadpleeg de Engelse versie voor een brontekst.

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

3 juni 2026 bijgewerkt door: 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.

Studie Overzicht

Toestand

Voltooid

Conditie

Interventie / Behandeling

Studietype

Ingrijpend

Inschrijving (Werkelijk)

153

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

  • Frankrijk
      • Nancy, Frankrijk
        • Nancy University Hospital

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Volwassen
  • Oudere volwassene

Accepteert gezonde vrijwilligers

Nee

Beschrijving

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

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Onderzoek naar gezondheidsdiensten
  • Toewijzing: NVT
  • Interventioneel model: Opdracht voor een enkele groep
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Case-management program
Patients included in the case-management program
Gedragsmatig: 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.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Effectiveness
Tijdsspanne: 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
Tijdsspanne: One year
Incremental cost-effectiveness ratio in cost per ED visit avoided
One year

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Indicator Reach 1 - Percentage of patients who consented to participate in the DAUM program among eligible patients
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Central Hospital, Nancy, France

Medewerkers

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

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Algemene publicaties

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

7 november 2022

Primaire voltooiing (Werkelijk)

31 oktober 2024

Studie voltooiing (Werkelijk)

31 oktober 2024

Studieregistratiedata

Eerst ingediend

19 mei 2026

Eerst ingediend dat voldeed aan de QC-criteria

3 juni 2026

Eerst geplaatst (Werkelijk)

9 juni 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

9 juni 2026

Laatste update ingediend die voldeed aan QC-criteria

3 juni 2026

Laatst geverifieerd

1 juni 2026

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • 2022_PI_095

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

NEE

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

Abonneren