Establishing evidence-based strategic recommendations
for patient-centred health care options for individuals
experiencing high use of the emergency department.

Acronym: HEDU

   Individuals who experience high use of the emergency department (≥5 or more visits per year) represent 8-10% of the patient population, however, contribute up to one-third of total emergency department visits and one-fifth of total emergency department costs.

   There are many factors that contribute to experiencing high use of the emergency department and these can be classified as individual-level, health system-level, and community-level. Although various models of integrated and coordinated care have been implemented to reduce visits that may be addressed in other health care settings, their results are mixed. Additionally, there are gaps in the body of knowledge on the interplay between individual-level, health system-level, and community-level influences on high use of the emergency department.

   This project aims to establish evidence-based strategic recommendations for patient-centred health care options expected to reduce non-urgent emergency department visits by employing a mixed methods approach to studying adults, 18 years of age and older, who experience high use of the emergency department (≥5 visits per year) in the city of Krakow, Poland. This will be achieved through four related objectives:

1) to prepare a patient profile for individuals experiencing high use of the emergency department;

2) to examine changes in health care utilization among this population over the course of the COVID-19 pandemic;

3) to carry out focus groups with relevant stakeholder groups to gather information on the reasons for high emergency department use;

4) to establish evidence-based strategic recommendations for patient-centred health care options for individuals experiencing high emergency department use.

   This information is necessary to advance equitable health care among this population in Europe, while at the same time lessening pressures on overburdened systems and ensuring the proper use of services given finite health resources. This is especially critical during extraordinary stresses on the health system.

   The study results will be applicable to urban health systems in Europe. They will be disseminated to stakeholder groups, including patients, health care workers, academics, and policy makers.

Contact details

Principal Investigator:

Dr Iwona Bielska

Assistant Professor

Jagiellonian University Medical College;

Faculty of Health Sciences;

Institute of Public Health

Skawińska 8, 31-066 Kraków

tel. 12 43-32-810

e-mail: iwona.bielska@uj.edu.pl

Project Mentor:

Dr hab. Iwona Kowalska-Bobko

Professor

Jagiellonian University Medical College;

Faculty of Health Sciences;

Institute of Public Health

Skawińska 8, 31-066 Kraków

tel. 12 43-32-814

e-mail: iw.kowalska@uj.edu.pl

Project Location:

Jagiellonian University Medical College, Faculty of Health Sciences, Institute of Public Health

Skawińska 8, 31-066 Kraków

website: http://izp.wnz.cm.uj.edu.pl/en/main-page/

This research is part of the project No. 2021/43/P/NZ7/02019 co-funded by the National Science Centre and the European Union’s Horizon  2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 945339.