Table 1. Patient Education on Health Care Use.
| Author/Year | Design | Population | Intervention | Effect on ED Use | Effect on Non-ED Use | Other Outcomes |
|---|---|---|---|---|---|---|
| Intervention: Booklet | ||||||
| Glavan et al. (1998)10 | Pre–post interventional study United States 6 months |
Air Force base Intervention group: 1,555 subjects Control group: 972 subjects |
Subjects in intervention group were given a self-care book with an information session on how to use the book | Intervention group: reduction in ED use rate per person from 0.353 to 0.279 (p = 0.02) Control group: increase in ED use rate per person from 0.386 to 0.421 |
Intervention group: reduction in clinic use rate per person from 1.072 to 1.038 Control group: increase in clinic visits rate per person from 1.040 to 1.168 | Not reported |
| Rector et al. (1999)14 | Randomized, parallel group study United States January–July 1998 |
Two urban Medicaid health plans (Plan A and B) Intervention group: house holds sent educational brochure Control group: households not sent educational brochure |
Households were randomized to receive a booklet, First Look, about care of common nonurgent conditions | Nonsignificant reductions in ED use of 1.1% (Plan A, 95% CI = −3.1% to 0.8%) and −1.2% (Plan B, 95% CI = −4.1% to 1.4%) | No difference in either plan in physician office visits | |
| Intervention: Training Sessions | ||||||
| McWilliams et al. (2008)11 | Retrospective cohort-control study, difference-in-difference model United States 12 months |
Primary care practices at academic health center Intervention group: 191 patients in practice Control groups:
|
Nurses provided standardized education along with prescription for pain relieving ear drops Parents reminded of 24-hour medical advice telephone access |
Reduction in ED use for ear pain by 80.3% (p = 0.009) at intervention site. Concurrent control site had 25% nonsignificant increase in ED use |
Nonsignificant reductions in urgent care center use by 40.3% (p = 0.33), and primary care center use by 27.8% (p = 0.14) at intervention site. In control site, 28% reduction in urgent care use, and a 4% reduction in primary care use | 3-year medical record review of all children in the intervention group revealed no episodes of mastoiditis |
| Rettig et al. (1986)12 | Randomized controlled trial United States One year |
Multiple home health nursing agencies Intervention group: 180 diabetic patients Control group: 193 diabetic patients |
Diabetic patients in the intervention group underwent home teaching sessions on diabetic health problems | Nonsignificant reduction in ED visits in intervention vs. control group (0.06 vs. 0.08) (nonsignificant) | Nonsignificant increase in primary care visits within 6 months by intervention vs. control group (3.11 vs. 2.78) | Nonsignificant changes in hospitalization rates/1,000 members/year in intervention group vs. control group:
|
| Schonlau et al. (2005)13 | Pre–post interventional study United States |
Primary health care centers recruited through Break through Series Collaborative Intervention group: three sites with 109 patients Control group: two sites with 76 patients | Asthmatic patients at intervention sites underwent educational sessions | Nonsignificant differences in acute care visits between groups (1.72 vs. 0.92 average visits; p = 0.08) | Not reported | No significant difference in quality of life, number of bed days, and acute care service use |