title: Effectiveness of case management strategies in reducing emergency department visits in frequent user patient populations: a systematic review.
abstract: BACKGROUND
  Case management (CM) is a commonly cited intervention aimed at reducing Emergency Department (ED) utilization by "frequent users," a group of patients that utilize the ED at disproportionately high rates. Studies have investigated the impact of CM on a variety of outcomes in this patient population.
  
  
  OBJECTIVE
  We sought to examine the evidence of the effectiveness of the CM model in the frequent ED user patient population. We reviewed the available literature focusing on the impact of CM interventions on ED utilization, cost, disposition, and psychosocial variables in frequent ED users.
  
  
  CONCLUSIONS
  Although there was heterogeneity across the 12 studies investigating the impact of CM interventions on frequent users of the ED, the majority of available evidence shows a benefit to CM interventions. Reductions in ED visitation and ED costs are supported with the strongest evidence.
  
  
  CONCLUSIONS
  CM interventions can improve both clinical and social outcomes among frequent ED users.
authors.affiliation: Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: Gayathri S
authors.initials: GS
authors.lastname: Kumar
authors.forename: Robin
authors.initials: R
authors.lastname: Klein
mesh_terms: D019090:Case Management / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D006304:Health Status; D017721:Hospital Costs; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D017146:Models, Organizational; D017063:Outcome Assessment, Health Care; D012959:Socioeconomic Factors; D014481:United States