Frequent Users of Health Services Initiative:  Final Evaluation Report

Karen W. Linkins, Jennifer J. Brya, and Daniel W. Chandler, PhD

August 2008

The Frequent Users of Health Services Initiative was a five-year, $10 million project jointly funded by The California Endowment and the California HealthCare Foundation.  Frequent users are a small group of individuals with complex, unmet needs not effectively addressed in the high-cost acute care settings of emergency departments. These individuals face barriers in accessing housing and medical, mental health, and substance abuse treatment, all of which can contribute to frequent emergency department visits. The goal of the initiative was to promote the development and implementation of innovative, integrated approaches to addressing the comprehensive health and social service needs of frequent users of emergency departments.  The initiative was designed to develop and test new models to serve this population more effectively, replacing a costly and avoidable health care utilization pattern with ongoing, coordinated, and multidisciplinary care provided in more appropriate settings. At the heart of the initiative were the demonstration projects that tested new models of care for frequent users throughout California.  Researchers found that homeless clients connected to permanent housing had greater reductions in emergency department use and charges compared to those who remained homeless:  34% fewer emergency department visits, 27% fewer inpatient admissions, and 27% fewer inpatient days. 

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