STUDY PROTOCOL Open Access
Case management for frequent users of the
emergency department: study protocol of a
randomised controlled trial
Patrick Bodenmann
1*
, Venetia-Sofia Velonaki
2
, Ornella Ruggeri
2
, Olivier Hugli
3
, Bernard Burnand
4
,
Jean-Blaise Wasserfallen
5
, Karine Moschetti
5,6
, Katia Iglesias
4
, Stéphanie Baggio
7
and Jean-Bernard Daeppen
8
Abstract
Background: We devised a randomised controlled trial to evaluate the effectiveness and efficiency of an intervention
based on case management care for frequent emergency department users. The aim of the intervention is to reduce
such patients’ emergency department use, to improve their quality of life, and to reduce costs consequent on frequent
use. The intervention consists of a combination of comprehensive case management care and standard emergency
care. It uses a clinical case management model that is patient-identified, patient-directed, and developed to provide
high intensity services. It provides a continuum of hospital- and community-based patient services, which include
clinical assessment, outreach referral, and coordination and communication with other service providers.
Methods/Design: We aim to recruit, during the first year of the study, 250 patients who visit the emergency
department of the University Hospital of Lausanne, Switzerland. Eligible patients will have visited the emergency
department 5 or more times during the previous 12 months. Randomisation of the participants to the intervention or
control groups will be computer generated and concealed. The statistician and each patient will be blinded to the
patient’s allocation. Participants in the intervention group (N = 125), additionally to standard emergency care, will
receive case management from a team, 1 (ambulatory care) to 3 (hospitalization) times during their stay and after 1, 3,
and 5 months, at their residence, in the hospital or in the ambulatory care setting. In between the consultations
provided, the patients will have the opportunity to contact, at any moment, the case management team. Participants
in the control group (N = 125) will receive standard emergency care only. Data will be collected at baseline and 2, 5.5,
9, and 12 months later, including: number of emergency department visits, quality of life (EuroQOL and WHOQOL),
health services use, and relevant costs. Data on feelings of discrimination and patient’s satisfaction will also be collected
at the baseline and 12 months later.
Discussion: Our study will help to clarify knowledge gaps regarding the positive outcomes (emergency department
visits, quality of life, efficiency, and cost-utility) of an intervention based on case management care.
Trial registration: ClinicalTrials.gov Identifier: NCT01934322.
Keywords: Randomised controlled trial, Case management, Emergency department, Frequent users, Quality of life
* Correspondence: Patrick.Bodenmann@hospvd.ch
1
Department of Ambulatory Care and Community Medicine, University of
Lausanne, Lausanne CH-1015, Switzerland
Full list of author information is available at the end of the article
© 2014 Bodenmann et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the
Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use,
distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public
Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this
article, unless otherwise stated.
Bodenmann et al. BMC Health Services Research 2014, 14:264
http://www.biomedcentral.com/1472-6963/14/264