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. 2021 Feb 17;21(1):157.
doi: 10.1186/s12913-021-06154-4.

CONECT-6: a case-finding tool to identify patients with complex health needs

Catherine Hudon  1 , Mathieu Bisson  2 , Marie-France Dubois  2 , Yohann Chiu  2 , Maud-Christine Chouinard  3 , Nicole Dubuc  2 , Nicolas Elazhary  2 , Véronique Sabourin  4 , Alain Vanasse  2
Affiliations

CONECT-6: a case-finding tool to identify patients with complex health needs

Catherine Hudon et al. BMC Health Serv Res. .

Erratum in

Abstract

Background: Early identification of patients with chronic conditions and complex health needs in emergency departments (ED) would enable the provision of services better suited to their needs, such as case management. A case-finding tool would ultimately support ED teams to this end and could reduce the cost of services due to avoidable ED visits and hospitalizations. The aim of this study was to develop and validate a short self-administered case-finding tool in EDs to identify patients with chronic conditions and complex health needs in an adult population.

Methods: This prospective development and initial validation study of a case-finding tool was conducted in four EDs in the province of Quebec (Canada). Adult patients with chronic conditions were approached at their third or more visit to the ED within 12 months to complete a self-administered questionnaire, which included socio-demographics, a comorbidity index, the reference standard INTERMED self-assessment, and 12 questions to develop the case-finding tool. Significant variables in bivariate analysis were included in a multivariate logistic regression analysis and a backward elimination procedure was applied. A receiver operating characteristic (ROC) curve was developed to identify the most appropriate threshold score to identify patients with complex health needs.

Results: Two hundred ninety patients participated in the study. The multivariate analysis yielded a six-question tool, COmplex NEeds Case-finding Tool - 6 (CONECT-6), which evaluates the following variables: low perceived health; limitations due to pain; unmet needs; high self-perceived complexity; low income; and poor social support. With a threshold of two or more positive answers, the sensitivity was 90% and specificity 66%. The positive and negative predictive values were 49 and 75% respectively.

Conclusions: The case-finding process is the essential characteristic of case management effectiveness. This study presents the first case-finding tool to identify adult patients with chronic conditions and complex health needs in ED.

Keywords: Ambulatory care sensitive condition; Case management; Case-finding tool; Chronic diseases; Complexity; Frequent user.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of participants
Fig. 2
Fig. 2
ROC curve with 95% confidence interval
See this image and copyright information in PMC

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References

    1. Althaus F, Paroz S, Hugli O, Ghali WA, Daeppen JB, Peytremann-Bridevaux I, et al. Effectiveness of interventions targeting frequent users of emergency departments: a systematic review. Ann Emerg Med. 2011;58:41–52. doi: 10.1016/j.annemergmed.2011.03.007. - DOI - PubMed
    1. Blank FS, Li H, Henneman PL, Smithline HA, Santoro JS, Provost D, et al. A descriptive study of heavy emergency department users at an academic emergency department reveals heavy ED users have better access to care than average users. J Emerg Nurs. 2005;31:139–144. doi: 10.1016/j.jen.2005.02.008. - DOI - PubMed
    1. Doupe MB, Palatnick W, Day S, Chateau D, Soodeen RA, Burchill C, et al. Frequent users of emergency departments: developing standard definitions and defining prominent risk factors. Ann Emerg Med. 2012;60:24–32. doi: 10.1016/j.annemergmed.2011.11.036. - DOI - PubMed
    1. Hunt KA, Weber EJ, Showstack JA, Colby DC, Callaham ML. Characteristics of frequent users of emergency departments. Ann Emerg Med. 2006;48:1–8. doi: 10.1016/j.annemergmed.2005.12.030. - DOI - PubMed
    1. Hansagi H, Olsson M, Sjoberg S, Tomson Y, Goransson S. Frequent use of the hospital emergency department is indicative of high use of other health care services. Ann Emerg Med. 2001;37:561–567. doi: 10.1067/mem.2001.111762. - DOI - PubMed

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