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

3. juni 2026 oppdatert av: 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.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Studietype

Intervensjonell

Registrering (Faktiske)

153

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Frankrike
      • Nancy, Frankrike
        • Nancy University Hospital

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

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

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Helsetjenesteforskning
  • Tildeling: N/A
  • Intervensjonsmodell: Enkeltgruppeoppdrag
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Case-management program
Patients included in the case-management program
Atferdsmessig: 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.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Effectiveness
Tidsramme: 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
Tidsramme: One year
Incremental cost-effectiveness ratio in cost per ED visit avoided
One year

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Indicator Reach 1 - Percentage of patients who consented to participate in the DAUM program among eligible patients
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Central Hospital, Nancy, France

Samarbeidspartnere

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

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Studer hoveddatoer

Studiestart (Faktiske)

7. november 2022

Primær fullføring (Faktiske)

31. oktober 2024

Studiet fullført (Faktiske)

31. oktober 2024

Datoer for studieregistrering

Først innsendt

19. mai 2026

Først innsendt som oppfylte QC-kriteriene

3. juni 2026

Først lagt ut (Faktiske)

9. juni 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

9. juni 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

3. juni 2026

Sist bekreftet

1. juni 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • 2022_PI_095

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