NEW DIRECTIONS AN INTENSIVE CASE MANAGEMENT PROGRAM

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NEW DIRECTIONSAN INTENSIVE CASE MANAGEMENT
PROGRAM
Frequent Users of Healthcare Initiative
Meeting September 2006
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DATA COLLECTED

• At enrollment, 6 months, 18 months
• FUI Demographics Functional Status
• FUI assessment tools (Lehman Qof L,
• SF12, Stages of Change)

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DATA COLLECTED (contd)

• For Prior Year, Yr. 1, Yr. 2, and Yr. 3
• of ED visits, admissions, hospital days, clinic
  visits
• Direct costs for ED, inpatient, outpatient care
• of ambulance rides
• Mental health contacts
• DADS contacts
• Direct Costs Costs for direct care only, no
  overhead, administrative, or indirect costs

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DATA COLLECTED (contd)

• Staff contact log
• Disenrollment log

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METHODOLOGY

• Compare Prior Yr. to Yr. 1, Yr. 2, Yr. 3
• Eventually compare a control group of 40 clients
  to the case managed group of clients

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ANALYSIS 1

• COMPARE
• Prior Year vs. Yr 1, Yr. 2, and Yr. 3
• Percent change in visits/admits/hospital days
• Number of visits/admits/hospital days
• Percent change in direct costs of ED/inpt./outpt.
  care
• Direct costs in dollars of ED/inpt./outpt. care
• Visits ED, Outpt, MH, DADS visits

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ANALYSIS 2

• Separate clients by those that were successful
  vs. unsuccessful
• Successful ED visits decreased below the
  threshold for program (i.e. less than 8 visits /
  year)
• Unsuccessful ED visits continue with more than
  8 ED visits / year
• Complete analysis 1 for both groups

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RESULTS Hospital B

• 46 Clients followed for 2 years
• 85 Success Rate (39 out of 46 reduced ED visits
  to lt 8)
• Successful Clients (39)
• ED visits decreased 80 in Yr. 2
• Hospital ED Costs decreased (-98,234) in Yr. 2
• 39 clients 40 of total case load
• For total case load of current program - costs
  would decrease by 245,500 for all clients

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RESULTS Hospital B (contd)

• Unsuccessful Clients (7)
• ED visits increased in Yr. 1 by 18, decreased
  only 3 in Yr.2
• ED costs increased in Yr. 1 (52) and Yr. 2 (65)
• Hospital and ED costs increased in Yr. 1
  (39,000) and Yr. 2 (68,700)
• In Yr. 2 outpatient costs increased more for
  these 7 clients than all 39 successful
  clients(57,000 vs. 23,500)

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RESULTS Successful Clients (85)
Hospital B Change in ED Utilization Costs Yr
1 Yr 2
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RESULTS Unsuccessful Clients (15)
Hospital B Change in ED Utilization Costs Yr
1 Yr 2
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RESULTS Successful Clients (85)
Hospital B Change in Hosp. Outpt. Costs --Yr 1
Yr 2
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RESULTS Unsuccessful Clients (15)
Hospital B Change in Hosp. Outpt. Costs --Yr 1
Yr 2