Perspectives of Frequent Users of Emergency Departments on a Case Management Intervention: A Qualitative Study.

Autor:	Schaad L; Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, Lausanne University, Switzerland., Graells M; Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, Lausanne University, Switzerland., Kasztura M; Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, Lausanne University, Switzerland., Schmutz E; Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, Lausanne University, Switzerland., Moullin J; Curtin University, Perth, Western Australia, Australia., Hugli O; Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, Lausanne University, Switzerland., Daeppen JB; Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, Lausanne University, Switzerland., Ambrosetti J; Geneva University Hospital, Genève, Switzerland., Ombelli J; North Vaud Hospital Group, Yverdon-les-Bains, Switzerland., Golay M; Broye Intercantonal Hospital, Payerne, Switzerland., Ribordy V; Fribourg Hospital, Fribourg, Switzerland., Grazioli VS; Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, Lausanne University, Switzerland., Bodenmann P; Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, Lausanne University, Switzerland.
Jazyk:	angličtina
Zdroj:	Inquiry : a journal of medical care organization, provision and financing [Inquiry] 2023 Jan-Dec; Vol. 60, pp. 469580231159745.
DOI:	10.1177/00469580231159745
Abstrakt:	Background: Effective management of frequent users of emergency departments (FUED) remains challenging. Case management (CM) has shown to improve patient quality of life while reducing ED visits and associated costs. However, little data is available on FUED's perception of CM outside of North America to further improve CM implementation. Objectives: Explore the FUED's perspectives about CM in Switzerland. Design, Setting & Participants: Semi-structured qualitative interviews eliciting FUED's experiences of CM were conducted among 20 participants (75% female; mean age = 40.6, SD = 12.8) across 6 hospital ED. Outcomes Measures & Analysis: Inductive content analysis. Main Results: Most participants were satisfied with the CM program. In particular, FUEDs identified the working relationship with the case manager (cm) as key for positive outcomes, and also valued the holistic evaluation of their needs and resources. Overall, patients reported increased motivation and health literacy, as well as facilitated interactions within the healthcare system. Conversely, a small number of participants reported negative views on CM ( ie , stigmatization, lack of concrete outcomes). Barriers identified were cm's lack of time, COVID-19's negative impact on CM organization, as well as lack of clarity on the objectives of CM. FUED perceived CM as useful, in particular establishing a working relationship with the cm. Our results suggest that CM can be further improved by (1) professionals remaining non-judgmental toward FUED, (2) making sure the aims and objectives of the CM are understood by the participants, and (3) allowing more time for the cm to carry out their work.
Databáze:	MEDLINE
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