title: Comparative effectiveness of care coordination interventions in the emergency department: a systematic review.
abstract: OBJECTIVE
  To conduct a systematic review on the effectiveness of emergency department (ED)-based care coordination interventions.
  
  
  METHODS
  We reviewed any randomized controlled trial or quasi-experimental study indexed in MEDLINE, CINAHL, Web of Science, Cochrane, or Scopus that evaluated the effectiveness of ED-based care coordination interventions. To be included, interventions had to incorporate information from previous visits, provide educational services on continuing care, provide post-ED treatment plans, or transfer information to continuing care providers. Studies had to quantify information transfer or report ED revisits, hospitalizations, or follow-up rates. Randomized controlled trial quality was assessed with the Jadad score.
  
  
  RESULTS
  Of 23 included articles, 14 were randomized controlled trials and 9 were quasi-experimental studies. Randomized controlled trial quality ranged from 2 to 3 on a 5-point scale. The majority of the studies (17) were conducted at a single center. Of nineteen studies that developed post-ED plans, 12 were effective in improving follow-up rates or reducing repeated ED visits. Four studies found paradoxically higher ED visit rates. Of 4 that used educational services for continuing care, 2 were effective. Of the 2 evaluating information transfer, 1 was effective. One study assessed incorporating information from other sites and found higher rates of information transfer, but utilization was not studied.
  
  
  CONCLUSIONS
  The majority of ED-based care coordination interventions focus on interfacing with outpatient providers, and about two thirds have been effective in increasing follow-up rates or reducing repeated ED utilization. Other types of interventions have shown similar effectiveness, but fewer have been studied.
authors.affiliation: George Washington University School of Medicine, Washington, DC, USA.
authors.forename: Elyse B
authors.initials: EB
authors.lastname: Katz
authors.forename: Emily R
authors.initials: ER
authors.lastname: Carrier
authors.forename: Craig A
authors.initials: CA
authors.lastname: Umscheid
authors.forename: Jesse M
authors.initials: JM
authors.lastname: Pines
mesh_terms: D000553:Ambulatory Care / Q000458:organization & administration; D057186:Comparative Effectiveness Research; D003266:Continuity of Patient Care / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006801:Humans; D010353:Patient Education as Topic; D010360:Patient Transfer