A pilot mobile integrated healthcare program for frequent utilizers of emergency department services

Am J Emerg Med. 2017 Nov;35(11):1702-1705. doi: 10.1016/j.ajem.2017.04.061. Epub 2017 Apr 27.


Purpose: To examine whether or not a mobile integrated health (MIH) program may improve health-related quality of life while reducing emergency department (ED) transports, ED admissions, and inpatient hospital admissions in frequent utilizers of ED services.

Methods: A small retrospective evaluation assessing pre- and post-program quality of life, ED transports, ED admissions, and inpatient hospital admissions was conducted in patients who frequently used the ED for non-emergent or emergent/primary care treatable conditions.

Results: Pre- and post-program data available on 64 program completers are reported. Of those with mobility problems (n=42), 38% improved; those with problems performing usual activities (N=45), 58% reported improvement; and of those experiencing moderate to extreme pain or discomfort (N=48), 42% reported no pain or discomfort after program completion. Frequency of ED transports decreased (5.34±6.0 vs. 2.08±3.3; p <0.000), as did ED admissions (9.66±10.2 vs. 3.30±4.6; p<0.000), and inpatient hospital admissions (3.11±5.5 vs. 1.38±2.5; p=0.003).

Conclusion: Results suggest that MIH participation is associated with improved quality of life, reduced ED transports, ED admissions, and inpatient hospital admissions. The MIH program may have potential to improve health outcomes in patients who are frequent ED users for non-emergent or emergent/primary care treatable conditions by teaching them how to proactively manage their health and adhere to therapeutic regimens. Programmatic reasons for these improvements may include psychosocial bonding with participants who received in-home care, health coaching, and the MIH team's 24/7 availability that provided immediate healthcare access.

Keywords: Emergency medicine; Emergency utilization; Mobile integrated healthcare.

MeSH terms

  • Adult
  • Delivery of Health Care
  • Emergency Medical Services / statistics & numerical data*
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Health Education
  • Health Services Accessibility
  • Hospitalization / statistics & numerical data*
  • House Calls
  • Humans
  • Male
  • Mass Screening
  • Middle Aged
  • Mobile Health Units / organization & administration*
  • Pilot Projects
  • Primary Health Care*
  • Quality of Life*
  • Texas
  • Transportation of Patients / statistics & numerical data