Impact of case management on frequent users' quality of life : a randomized, controlled trial (FM 286)

Introduction: Frequent emergency department (ED) users are often vulnerable patients with many risk factors affecting their quality of life (QoL). The aim of this study was to examine to what extent a case management intervention improved frequent ED users' QoL. Methods: Data were part of a randomized, controlled trial designed to improve frequent ED users' QoL at the Lausanne University Hospital. A total of 194 frequent ED users (≥ 5 attendances during the previous 12 months; ≥ 18 years of age) were randomly assigned to the control or the intervention group. Participants in the intervention group received a case management intervention (i.e. counseling and assistance concerning social determinants of health, substance-use disorders, and access to the health-care system). QoL was evaluated using the WHOQOL-BREF at baseline and twelve months later. Four dimensions of QoL were retained: physical health, psychological health, social relationship, and environment, with scores ranging from 0 (low QoL) to 100 (high QoL).