Table 1.
Summary of Study Characteristics and Evidence Map
| STUDY DESIGN | AUTHOR(S) (YEAR) | STUDY GOAL | NO. OF ANALYZED FOLLOW-UP | UTILIZATION OUTCOMES | COST AND FINANCIAL OUTCOMES | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| ED USE | IP/OP VISIT READMIT | LENGTH OF STAY | OPIOID USE (O) IMAGING USE (I) | LAB BED DAY | COSTS | FINANCIAL METRICS | ||||
| RCT | Neven et al. (2016) | To reduce ED visits and decrease controlled substance prescriptions to high utilizers; to assess the ROI of the program | Treatment: 79 Control: 76 12 months |
+* | O: +*ED + *D | ? | + | |||
| Rathlev et al. (2016) | To assess the impact of electronic alerts on provider opioid prescribing behaviors, patient outcomes, and utilization | Treatment: 20 Control: 20 12 months |
− | −IP | O: −ED − IP +*D I: −CT/MRI (ED) |
− | ||||
| Ringwalt et al. (2015) | To reduce number of ED visits and opioid prescriptions for patients with chronic noncancer pain | Treatment: 13 Control: 16 12 months |
+* | O: +* ? ED |
||||||
| Pre/post | Adams and Nielson (2012) | To identify recently discharged psychiatric patients revisiting the ED, and to reduce hospital readmissions and ED visits | NR 12 months |
? | ||||||
| Chan et al.# (2009) | To examine the effect of referral appointment system in the ED on patient access to and adherence with follow-up post-ED visit | Pre: 399 Post: 326 6 months |
− | |||||||
| Hardin et al. (2017) | To reduce healthcare costs and improve outcomes for “high-risk, high-need” patients | Pre: 339 Post: 339 12 months |
+* | +*IP + *OP | +* | I: +*CT | +* | +* | ||
| Mercer et al. (2015) | To reduce unnecessary healthcare utilization through individualized care plans for high utilizers of ED and inpatient services | Pre: 24 Post: 23 (6 months), 12 (12 months) |
− − |
+* IP + *R +* IP + *R |
− − |
−ED +*IP −ED +IP |
||||
| Murphy and Neven (2014) | To examine the cost-effectiveness of computerized reminders about individualized care plans in the ED | Pre: 141 Post: 141 12 months |
+* | +*IP +*OP |
+* | +* | ||||
| Stokes-Buzzelli et al. (2010) | To examine the use of health IT to manage patients frequently presenting to the ED | Pre: 20 Post: 20 24 months |
+ | − | +*Lab | + | ||||
| Stowe (2011) | To evaluate the effect of an automated alert system for cancer patients presenting to the ED | NR 16 weeks |
? | ?Bed day | ? | ? | ||||
+* = statistically significant change; + = marginally significant; − = not significant; ? = unclear, p-value not reported. #: study reported significant change in adherence with follow-up.
D, prescribed upon discharge; CT: computed tomography; ED, emergency department, IP, hospital inpatient; MRI, magnetic resonance imaging; NR, not reported; OP, outpatient; R, readmission; RCT, randomized controlled trial; ROI, return on investment.