Evaluation of a Case-management Program for Frequent Emergency Department Users (DAUM)
2026年6月3日 更新者：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.
研究概览
研究类型
介入性
注册 (实际的)
153
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习地点
-
-
-
Nancy、法国
- Nancy University Hospital
-
-
参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
不
描述
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
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
- 主要用途：卫生服务研究
- 分配：不适用
- 介入模型：单组作业
- 屏蔽：无（打开标签）
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
实验性的：Case-management program
Patients included in the 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. |
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Effectiveness
大体时间：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
大体时间：One year
|
Incremental cost-effectiveness ratio in cost per ED visit avoided
|
One year
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Indicator Reach 1 - Percentage of patients who consented to participate in the DAUM program among eligible patients
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
|
合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
一般刊物
- Darraj A, Hudays A, Hazazi A, Hobani A, Alghamdi A. The Association between Emergency Department Overcrowding and Delay in Treatment: A Systematic Review. Healthcare (Basel). 2023 Jan 29;11(3):385. doi: 10.3390/healthcare11030385.
- Gabet M, Armoon B, Meng X, Fleury MJ. Effectiveness of emergency department based interventions for frequent users with mental health issues: A systematic review. Am J Emerg Med. 2023 Dec;74:1-8. doi: 10.1016/j.ajem.2023.09.008. Epub 2023 Sep 9.
- Reinhart L, Dechartres A, Beaune S, Bonnet-Zamponi D, Chauvin A, Yordanov Y. Clinical and sociodemographic factors associated with frequent use of emergency services by persons of advanced age in Paris: a nested case-control study. Emergencias. 2025 Feb;37(1):7-14. doi: 10.55633/s3me/114.2024. English, Spanish.
- Calastri C, Buckell J, Crastes Dit Sourd R. Avoidable visits to UK emergency departments from the patient perspective: A recursive bivariate probit approach. Health Policy. 2025 Apr;154:105265. doi: 10.1016/j.healthpol.2025.105265. Epub 2025 Feb 12.
- Sartini M, Carbone A, Demartini A, Giribone L, Oliva M, Spagnolo AM, Cremonesi P, Canale F, Cristina ML. Overcrowding in Emergency Department: Causes, Consequences, and Solutions-A Narrative Review. Healthcare (Basel). 2022 Aug 25;10(9):1625. doi: 10.3390/healthcare10091625.
- Ohaiba MM, Anamazobi EG, Okobi OE, Aguda K, Chukwu VU. Trends and Patterns in Emergency Department Visits: A Comprehensive Analysis of Adult Data From the National Center for Health Statistics (NCHS) Database. Cureus. 2024 Aug 3;16(8):e66059. doi: 10.7759/cureus.66059. eCollection 2024 Aug.
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (实际的)
2022年11月7日
初级完成 (实际的)
2024年10月31日
研究完成 (实际的)
2024年10月31日
研究注册日期
首次提交
2026年5月19日
首先提交符合 QC 标准的
2026年6月3日
首次发布 (实际的)
2026年6月9日
研究记录更新
最后更新发布 (实际的)
2026年6月9日
上次提交的符合 QC 标准的更新
2026年6月3日
最后验证
2026年6月1日
更多信息
与本研究相关的术语
其他相关的 MeSH 术语
其他研究编号
- 2022_PI_095
计划个人参与者数据 (IPD)
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