Using case management in a universal health coverage system to improve quality of life of frequent Emergency Department users: a randomized controlled trial

• Published in: Quality of life research 2018-02, Vol.27 (2), p.503-513
• Main Authors: Iglesias, Katia, Baggio, Stéphanie, Moschetti, Karine, Wasserfallen, Jean-Blaise, Daeppen, Jean-Bernard, Burnand, Bernard, Bodenmann, Patrick, Hugli, Olivier
• Format: Article
• Language: English
• Subjects: Case management; CLINICAL AND POLICY APPLICATIONS; Clinical trials; Emergency medical care; Emergency medical services; Intervention; Medicine; Medicine & Public Health; NCT; NCT01934322; Public Health; Quality of life; Quality of Life Research; Sociology
• ISSN: 0962-9343; 1573-2649
• DOI: 10.1007/s11136-017-1739-6

Purpose Frequent Emergency Department users are likely to experience poor quality of life (QOL). Case management interventions are efficient in responding to the complex needs of this population, but their effects on QOL have not been tested yet. Therefore, the aim of our study was to examine to what extent a case management intervention improved frequent Emergency Department users' QOL in a universal health coverage system. Methods Data were part of a randomized controlled trial designed to improve frequent Emergency Department users' QOL at the Lausanne University Hospital. Switzerland. A total of 250 frequent Emergency Department users (≥5 attendances during the previous 12 months) were randomly assigned to the control (n=125) or the intervention group (n=125). The latter benefited from case management intervention. QOL was evaluated using the WHOQOL-BREF at baseline, two, five and a half, nine, and twelve months later. It included four dimensions: physical health, psychological health, social relationship, and environment. Linear mixed-effects models were used to analyze the change in the patients' QOL over time. Results Patients' QOL improved significantly (p