Using case management in a universal health coverage system to improve quality of life of frequent Emergency Department users: a randomized controlled trial.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_D762CC887987
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Using case management in a universal health coverage system to improve quality of life of frequent Emergency Department users: a randomized controlled trial.
Journal
Quality of life research
Author(s)
Iglesias K., Baggio S., Moschetti K., Wasserfallen J.B., Hugli O., Daeppen J.B., Burnand B., Bodenmann P.
ISSN
1573-2649 (Electronic)
ISSN-L
0962-9343
Publication state
Published
Issued date
02/2018
Peer-reviewed
Oui
Volume
27
Number
2
Pages
503-513
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Frequent Emergency Department users are likely to experience poor quality of life (QOL). Case management interventions are efficient in responding to the complex needs of this population, but their effects on QOL have not been tested yet. Therefore, the aim of our study was to examine to what extent a case management intervention improved frequent Emergency Department users' QOL in a universal health coverage system.
Data were part of a randomized controlled trial designed to improve frequent Emergency Department users' QOL at the Lausanne University Hospital, Switzerland. A total of 250 frequent Emergency Department users (≥ 5 attendances during the previous 12 months) were randomly assigned to the control (n = 125) or the intervention group (n = 125). The latter benefited from case management intervention. QOL was evaluated using the WHOQOL-BREF at baseline, two, five and a half, nine, and twelve months later. It included four dimensions: physical health, psychological health, social relationship, and environment. Linear mixed-effects models were used to analyze the change in the patients' QOL over time.
Patients' QOL improved significantly (p < 0.001) in both groups for all dimensions after two months. However, environment QOL dimension improved significantly more in the intervention group after 12 months.
Environment QOL dimension was the most responsive dimension for short-term interventions. This may have been due to case management's assistance in obtaining income entitlements, health insurance coverage, stable housing, or finding general health care practitioners. Case management in general should be developed to enhance frequent users' QOL.
http://www.clinicaltrials.gov , Unique identifier: NCT01934322.

Keywords
Environment, Mental health, Physical health, Social relationship, Vulnerable population, WHOQOL
Pubmed
Web of science
Open Access
Yes
Create date
01/12/2017 16:49
Last modification date
20/08/2019 16:57
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