<?xml version='1.0' encoding='UTF-8'?><xml><records><record><source-app name="HighWire" version="7.x">Drupal-HighWire</source-app><ref-type name="Journal Article">17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Crane, Steven</style></author><author><style face="normal" font="default" size="100%">Collins, Lori</style></author><author><style face="normal" font="default" size="100%">Hall, James</style></author><author><style face="normal" font="default" size="100%">Rochester, Donald</style></author><author><style face="normal" font="default" size="100%">Patch, Steven</style></author></authors><secondary-authors></secondary-authors></contributors><titles><title><style face="normal" font="default" size="100%">Reducing Utilization by Uninsured Frequent Users of the Emergency Department: Combining Case Management and Drop-in Group Medical Appointments</style></title><secondary-title><style face="normal" font="default" size="100%">The Journal of the American Board of Family
                Medicine</style></secondary-title></titles><dates><year><style  face="normal" font="default" size="100%">2012</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2012-03-01 00:00:00</style></date></pub-dates></dates><pages><style  face="normal" font="default" size="100%">184-191</style></pages><doi><style  face="normal" font="default" size="100%">10.3122/jabfm.2012.02.110156</style></doi><volume><style face="normal" font="default" size="100%">25</style></volume><issue><style face="normal" font="default" size="100%">2</style></issue><abstract><style  face="normal" font="default" size="100%">Background: Patients with complex behavioral health and medical problems can have a disproportionate impact on emergency departments. Methods: We identified a cohort of 255 low-income, uninsured patients who had used inpatient or emergency department services more than 6 times in the previous 12 months. Between July 2010 and June 2011 we enrolled 36 of these high-risk patients to participate in a twice-weekly drop-in group medical appointment staffed by an interdisciplinary team of a family physician, behavioral health professional, and nurse case manager. The team provided 705 patient visits in a group setting (a total of 108 group sessions) and 652 case manager phone calls. The average number of clients per drop-in group medical appointment was 6.5. Results: Emergency department use dropped from a rate of 0.58 per patient per month to 0.23 (P &lt; .001), and hospital charges dropped from $1167 per patient per month to $230 (P &lt; .001). Employment status increased from 4 to 14 among the 36 patients enrolled. Total annualized cost of the program was $66,000. Conclusions: Team-based drop-in group medical appointments coupled with case management seem to be a cost-effective model to reduce emergency department visits by some patients with complex behavioral health and medical needs.</style></abstract></record></records></xml>