The program, called Operation Care, was conceived and implemented by the non-profit agency Baltimore HealthCare Access and ran as a three-month pilot in 2008. Now, a newly published report of its results appearing in The American Journal of Emergency Medicine can help illuminate strategies for other emergency medical services (EMS) departments around the country that may be plagued by the same problem, says the report's lead author.
"The original idea was to help these frequent callers get better access to medical and other care and, in doing so, Baltimore City ended up saving money and resources, a welcome side effect," says lead author Michael Rinke, M.D., a pediatrician and a quality and safety expert at Johns Hopkins Children's Center.
As fire departments around the country continue to get their budgets slashed, finding ways to trim costs while maintaining the same level of service will be increasingly important, the researchers say.
In three months, the program generated savings of more than $14,300, more than $6,300 of which was for the city fire department. The real savings are probably greater, as this number did not factor in any money saved from unnecessary trips to the ER and freeing up ambulances for other callers.
The Baltimore City Fire Department, which responds to nearly 150,000 emergency calls each year, has continued to fund the program, providing a nurse and a case manager for repeat 911 callers.
In 2007, two Baltimore City residents were responsible for more than 60 emergency calls, another resident made 110 calls to 911, and yet another one made 147 such calls, the investigators say. Each 911 call requires EMS to dispatch an ambulance to the caller.
Repeated 911 callers, the researchers reasoned, may face problems such as lack of health insurance and access to routine medical care or an inability to navigate the labyrinth of healthcare services. The findings of the study suggest they were mostly right. Examining a year's worth of 911 call logs, the researchers identified Baltimore City's 25 most frequent 911 callers, 10 of whom enrolled in the three-month program for weekly sessions with a case worker who assessed their medical needs, taught them how to navigate the health care system, put them in touch with primary care physicians and specialists, referred them to various support programs and educated them on ways to limit 911 calls to true emergencies.
Collectively, the 10 callers made 520 calls to 911 in the year preceding their enrollment. Based on their call pattern from the previous year, the researchers estimated that these 10 people would make 100 calls to 911 during the three months of the program. Somewhat to the researchers' surprise, there were only 57 calls, nearly half as many as they had predicted.
Nine of the 10 patients had insurance, mostly through Medicare. All 10 patients had two or more chronic conditions, including hypertension, diabetes and heart disease. Seven had either a mental health or a substance abuse problem or both. The average age was 60 years, ranging from 39 to 89 years. The case manager referred patients to insurance assistance programs, medical specialists, adult-care services, food services like Meals on Wheels, psychiatric evaluation and support groups for substance abuse. Nearly 70 percent of the referrals were to non-medical services.
"This program highlights the importance of simple interventions that can yield powerful results," says co-investigator Kathleen Westcoat, M.P.H., of Baltimore HealthCare Access. "For example making sure that a diabetic patient doesn't run out of strips for the glucose monitor can prevent a frantic 911 call for a non-emergency."
None of the patients reported that they hesitated to call 911 in true emergencies and said that they experienced no adverse health effects as a result of the program.
The investigators caution that though these findings are insightful, their relevance is difficult to gauge because they are based on a small number of patients.
Co-investigators on the report include Elisabeth Dietrich, B.A., of the Baltimore City Health Department, now at the University of California-San Francisco; and Traci Kodeck, M.P.H., of Baltimore HealthCare Access.
Ekaterina Pesheva | EurekAlert!
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The Fraunhofer FEP has been involved in developing processes and equipment for cleaning, sterilization, and surface modification for decades. The CleanHand Network for development of systems and technologies to clean surfaces, materials, and objects was established in May 2018 to bundle the expertise of many partnering organizations. As a partner in the CleanHand Network, Fraunhofer FEP will present the Network and current research topics of the Institute in the field of hygiene and cleaning at the parts2clean trade fair, October 23-25, 2018 in Stuttgart, at the booth of the Fraunhofer Cleaning Technology Alliance (Hall 5, Booth C31).
Test reports and studies on the cleanliness of European motorway rest areas, hotel beds, and outdoor pools increasingly appear in the press, especially during...
The building blocks of matter in our universe were formed in the first 10 microseconds of its existence, according to the currently accepted scientific picture. After the Big Bang about 13.7 billion years ago, matter consisted mainly of quarks and gluons, two types of elementary particles whose interactions are governed by quantum chromodynamics (QCD), the theory of strong interaction. In the early universe, these particles moved (nearly) freely in a quark-gluon plasma.
This is a joint press release of University Muenster and Heidelberg as well as the GSI Helmholtzzentrum für Schwerionenforschung in Darmstadt.
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Thin-film solar cells made of crystalline silicon are inexpensive and achieve efficiencies of a good 14 percent. However, they could do even better if their shiny surfaces reflected less light. A team led by Prof. Christiane Becker from the Helmholtz-Zentrum Berlin (HZB) has now patented a sophisticated new solution to this problem.
"It is not enough simply to bring more light into the cell," says Christiane Becker. Such surface structures can even ultimately reduce the efficiency by...
A study in the journal Bulletin of Marine Science describes a new, blood-red species of octocoral found in Panama. The species in the genus Thesea was discovered in the threatened low-light reef environment on Hannibal Bank, 60 kilometers off mainland Pacific Panama, by researchers at the Smithsonian Tropical Research Institute in Panama (STRI) and the Centro de Investigación en Ciencias del Mar y Limnología (CIMAR) at the University of Costa Rica.
Scientists established the new species, Thesea dalioi, by comparing its physical traits, such as branch thickness and the bright red colony color, with the...
Scientists have succeeded in observing the first long-distance transfer of information in a magnetic group of materials known as antiferromagnets.
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