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Am J Emerg Med. 2015 Dec;33(12):1799-801. doi: 10.1016/j.ajem.2015.08.038. Epub 2015 Aug 28.

Care plans reduce ED visits in those with drug-seeking behavior.

Author information

1
Morristown Medical Center, Department of Emergency Medicine, Morristown, NJ. Electronic address: ffiesseler@yahoo.com.
2
Rutgers Robert Wood Johnson Medical School, Department of Emergency Medicine, New Brunswick, NJ.
3
Morristown Medical Center, Department of Emergency Medicine, Morristown, NJ.
4
Charles E Schmidt College of Medicine Florida Atlantic University, Department of Integrated Medical Science, Boca Raton, FL.

Abstract

Patients with drug-seeking behavior can be both labor and resource intensive to the emergency department (ED).

OBJECTIVE:

To determine the effectiveness of ED care plans for individuals at high risk for drug-seeking behavior on ED visits.

METHODS:

A retrospective, cohort observational study.

LOCATION:

A suburban teaching hospital with an annual census of 80,000 patients. The number of ED visits was determined 1 year before and 2 subsequent years following care plan initiation.

EXCLUSION CRITERIA:

Unclaimed letter, incomplete data, and/or non-drug-seeking care plan.

STATISTICS:

Two-tailed Wilcoxon signed-rank test with significance of P < .05.

RESULTS:

Sixty patients were enrolled and 7 were excluded, leaving 53 patients for analysis. Mean annual visits before care plan initiation were 7.6 (95% confidence interval [CI], 6.3-9.1). One year following implementation, mean visits decreased to 2.3 (95% CI, 1.5-3.1) (P ≤ .0001). Two years following implementation, mean visits continued to decline to 1.5 (95% CI, 0.9-2.1) (P ≤ .0001). A significant reduction in visits occurred 1 and 2 years following care plan implementation.

CONCLUSIONS:

Emergency department care plans are an effective method to reduce ED visits in those with drug-seeking behavior.

PMID:
26472507
DOI:
10.1016/j.ajem.2015.08.038
[Indexed for MEDLINE]

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