Table 2 Reported measures and outcomes

Sandberg et al. [66] (2015) Sweden

Case management

No. of admissions, mean

0.62

0.48

0.48

0.49

No

LOS, mean

3.90

4.05

5.05

4.60

No

No. of ED visits leading to hospitalization, mean

0.36

0.42

0.39

0.34

No

No. of ED visits not leading to hospitalization, mean

0.22

0.37

0.15

0.08

Yes

Proportion of ED visits not leading to hospitalisation

16 (38.1%)

23 (46.7%)

12 (27.9%)

4 (17.4%)

Yes

No. of outpatient visits, mean

6.10

5.29

5.30

4.09

Yes

Haldiman et al. [40] (2014) the United States

Prospective review

No. of FFPs transfused per 1000 patients discharged per year

–

–

–

Y1: 66.7

Y4: 46.9

- 19.8 (−29.7%)

Yes

No. of platelets transfused per1000 patient discharged per year

–

–

–

Y1: 23.7

Y2: 18.7

-5 (−21.1%)

Yes

Annual cost savings

$130,000,000

NR

Goodnough et al. [37] (2014) the United States

Concurrent review

% of blood transfusions in patients whit HB levels exceeded 8 g/dl

–

–

–

57%

30%

Yes

Total RBC transfusions

–

–

–

–

− 7186

(−24%)

NR

Total plasma transfusions

–

–

–

–

–

−10%

NR

Total platelets transfusions

–

–

–

–

–

−12%

NR

All blood components

–

–

–

–

–

−19%

NR

Net savings

$1,616,750

NR

Joo [46] (2014) the United States

Case management

No. of Admissions

–

–

–

Y1: 0.62

Y2: 0.47

Yes

Total LOS

–

–

–

Y1: 3.05

Y2: 2.28

No

NO. of ED visits

–

–

–

Y1: 0.38

Y2: 0.36

No

Symptom control

–

–

–

B: 4.07

Y1: 4.19

Y2: 4.27

Yes

Quality of life

–

–

–

B: 3.89

Y1: 4.01

Y2: 4.03

Yes

Personal well-being

–

–

–

B: 4.09

Y1: 4.13

Y2: 4.14

No

Buckley et al. [24] (2013) the United States

Drug-utilisation management program

The proportion of patients prescribed epoetin

–

–

–

2.4%

1.6%

Yes

No. of patients inappropriately prescribed epoetin

–

–

–

184/496 (37.1%)

37/300 (12.3%)

Yes

Total no. of epoetin units administered

–

24,531,340

13,511,800

−45%

Yes

Total epoetin costs

–

–

–

$220,786 ($36,797/mo)

$121,606 ($20,268/mo)

−45%

Yes

% of total costs was attributed to inappropriate epoetin prescribing

–

–

–

36.8%

13%

Yes

Annual cost savings

$ 198,352 ($ 16,529/mo)

Yes

Reinius et al. [62]

(2013) Sweden

Case management

No. of ED visits

–

6.4

–

–

4.9

–

RRs 0.77; 95% CI 0.69-0.87

No. of admissions, mean

–

2.1

–

–

1.7

–

No

No. of hospital days per patient per year

–

16.9

–

–

7.0

−58%

Yes

No. of out-patient visits, mean

–

25.4

–

–

21.4

−15.7%

RRs 0.85; 95% CI 0.79–0.90

Costs per patient per year

–

€26,490

–

–

€11,417

−57%

Yes

Quality-of-life scores

–

–

–

–

–

–

Yes

Crane et al. [30]

(2012) the United States

Case management

No. of ED visits, median

6.96

5.04

−1.92

6.96

2.76

−4.2

Yes

Total ED and inpatient charges per patient per mon, mean

–

–

–

$1167

$230

-$937

Yes

Roland et al. [64] (2012) the United Kingdom

Case management

No. of emergency admissions

–

–

–

–

–

+ 9%

Yes

No. of elective admissions

–

–

–

–

–

−21%

Yes

No. of out-patient visits

–

–

–

–

–

−22%

Yes

Inpatient and out-patient costs

–

–

–

–

–

-£223

−9%

Yes

Koehler et al. [49] (2009) the United States

Care coordination

No. of 0-30 day post-discharge readmissions/ ED visits

–

8 (38%)

–

–

2 (10%)

Yes

No. of 31-60 day post-discharge readmissions/ED visits

–

1 (4.8%)

–

–

4 (20%)

No

Total post-discharge readmissions/ED visits at 60 days

–

9 (42.9%)

–

–

6 (30%)

No

Schraeder et al. [67] (2008) the United States

Case management

Admissions, %

–

53.8

–

–

51

–

No

Hospital bed days, mean

–

13.89

–

–

8.19

–

Yes

ED visits, mean

–

1.79

–

–

1.48

–

No

Readmissions

–

28.8%

–

–

19.2%

−34%

Yes

Cost of care per patient per mon, mean

–

$708

–

–

$1193

-$485

Yes

Adjusted cost of care per patient per mon (cost savings)

–

–

–

–

–

$106

No

Holsinger et al. [42] (2008) the United States

Collaborative model

1-day hospital stays

–

–

–

–

–

−19%

NR

Sweeney et al. [77] (2007) the United States

Patient-centred management

No. of admission, mean

–

1.9

–

–

1.2

−36.8%

Yes

Hospital days, mean

–

13.4

–

–

8.5

−36.6%

Yes

No. of ED visits, mean

–

1.5

–

–

1.0

−33.3%

No

Rehabilitation days, mean

–

5.8

–

–

3.7

−36.2%

No

Hospice days, mean

–

2.4

–

–

3.3

37.5%

No

Home care days, mean

–

30.9

–

–

36.8

26.6%

No

The overall cost per patient for 18 mon, mean

–

$ 68,341

–

–

$ 49,742

$ -18,599

(−27.2%)

NR

Phillips et al. [59]

(2006) Australia

Case management

Admissions, sum of the percentage

–

–

–

1104

931

No

No. of ED visits, mean

–

–

–

10.2

13.0

+ 2.8 (27.4%)

No P = 0.55

ED LOS, minutes, mean

–

–

–

297

300

+ 3

No

No. of ED overnight observation, mean

–

–

–

1.3

3.4

+ 2.1 (166%)

Yes

Housing stability score

–

–

–

3.6

4.1

0.5 (14%)

Yes

Primary care engagement score

–

–

–

2.6

3.1

0.5 (19%)

Yes

Community care engagement score

–

–

–

2.1

3.2

1.1 (52%)

Yes

Drug and alcohol use

–

–

–

68.3%

58.9%

No

Sledge et al. [73] (2006) the United States

Case management

No. of admissions, mean

2.0

1.7

−0.3

1.9

1.3

−0.6

No

No. of ED visits, mean

3.3

2.7

−0.6

2.0

1.5

−0.5

No

No. of clinic visits, mean

5.9

5.7

−0.2

6.4

7.9

+ 1.5

Yes

Total cost, mean

$17,721

$15,447

-$2274

$17,265

$16,291

-$974

No

SF-36 Mental Health Function Score

21.7

22

0.3

21.3

21.4

0.1

No

Overall patient satisfaction

7.24

6.7

−0.54

7.47

7.6

0.13

No

Mahendran et al. [54] (2006) Singapore

Case management

No. of readmissions

–

–

–

65

26

−39

Yes

No. of patients who defaulted follow-up appointments

–

–

–

All outpatient: 24%

CM patient: 11.9%

Yes

No. of days per admission, mean

–

–

–

15.6

4

−11.6

Yes

Zemencuk et al. [85] (2006) the United States

Physician profiling

LOS

–

–

–

–

–

− 0.32 day

Yes

Latour et al. [52]

(2006) the Netherlands

Case management

Readmission rate

–

11 (15.9%)

–

–

16 (20.6%)

–

No

Quality of life

–

–

–

–

–

–

No

Psychological functioning

–

–

–

–

–

–

No

Hegney et al. [41]

(2006) Australia

Discharge planning using risk screening tool

ED revisitation rate

–

–

–

21%

5%

−16%

Yes

Readmission rate

–

–

–

9 (10.2%)

7 (4.7%)

−2 (5.5%)

No

ALOS

–

–

–

6.17

5.37

−0.8

NR

Horwitz

et al. [43] (2005) the United States

Case management

No. of admission

–

7/109

(6.4%)

–

–

3/121 (2.5%)

No

No. of ED visits

–

32/109 (29.4%)

–

–

38/121 (31.4%)

No

Primary care contact in 60 days

–

15/109 (13.8%)

–

–

62/121 (51.2%)

Yes

Cost of an ED visit, mean

$330

$319

$330

$243

NR

Leung et al. [53] (2004) China

Case management

Total no. of admissions, mean

1.4

2.7

3.0

2.3

Yes

Total no. of hospital bed days, mean

6.8

10.7

12.9

9.6

Yes

Total no. of visits, mean

0.4

0.8

0.5

0.3

No

Total no. of outpatient visits, mean

6.7

6.9

9.0

8.3

Yes

Cox et al. (2003) [29] the United States

Case management

No. of admissions, mean

–

–

–

3.11

0.82

−2.29

Yes

Hospital days, mean

–

–

–

46.6

12.4

−34.2

Yes

Cost-saving per inpatient day

–

–

–

–

–

$ 166

Yes

Hwang et al. [44]

(2002) Korea

Physician’s order entry system

LOS, mean

–

–

–

11.4

8.2

−3.2

Yes

No. of daily orders

–

–

–

10.9

18.9

+ 8

Yes

No. of stat lab tests

–

–

–

3.3

1.8

−1.5

Yes

Fateha [34] (2002) Bahrain

Concurrent Review

LOS, mean

–

–

–

8.3

6.6

−1.7 (−20.5%)

Yes

Ferrazzi et al. [35] (2001) Canada

Advanced life support drug treatment given by ambulance attendants

Proportion of admissions

–

–

–

145 (67.4%)

102 (54.3%)

Yes

ED LOS, min, mean

–

–

-

206.9

220.9

−14

No

Ambulance scene time, min

–

–

–

12.3

14.2

Yes

Okin et al. [57] (2000) the United States

Case management

No. of ED visits, median

–

–

–

15

9

−6 (−40%)

Yes

No. of out-patient visits, median

–

–

–

2

4

Yes

No. of admissions, median

–

–

–

1

1

No

Medical inpatient days, median

–

–

–

5

2

No

ED costs, median

–

–

–

$4124

$2195

$-1938

Yes

Medical inpatient costs, median

–

–

–

$8330

$2786

$-1082

Yes

Medical out-patient costs, median

–

–

–

$476

$612

$94

No

Homelessness

–

–

–

35

15

−20 (−57%)

Yes

Alcohol use

–

–

–

37

29

−8 (−22%)

Yes

Drug use

–

–

–

27

20

−7 (−26%)

Yes

Linkage to primary care

–

–

–

–

–

+ 74%

Yes

Net cost savings

$132,726

NR

Bates et al. [22]

(1999) the United States

Computerised physician order entry

No. of clinical laboratory orders that were cancelled in response to reminders

–

Not applicable

–

–

300 of 437 (69%)

–

Yes

The proportion of the redundant tests that were performed

–

257 (51%)

–

–

117 (27%)

–

Yes

Annual lab cost savings

$35,000

NR

Wickizer et al. [82] (1998) the United States

Utilisation management strategies

No. of days approved

–

–

–

–

–

−50%

Yes

Spillane et al. [74] (1997) the United States

Case management

No. of ED visits, median

13

6

−7

14

7

−7

NO

Bree et al. [23]

(1996) the United States

Pre-certification

No. of examinations per admission, mean

–

4.4

–

–

4.4

–

No

LOS, mean

–

6.1

–

–

6.0

–

No

% of patients with one or more tests

–

88.7%

–

–

88%

–

No

Relative value units (RVUs), mean.

–

336.0

–

–

356.1

–

No

Adjusted RVUs

–

−10.2

–

–

−8.8

–

No

Shea et al. [69]

(1995) the United States

Clinical information system

Adjusted LOS, mean

–

0.012

–

–

−0.011

−2.3%

Yes

Cardiff et al. [26]

(1995) Canada

Utilisation management

Inappropriate admissions

C: 26 (18%)

D: 36 (23%)

C: 18 (13%)

D: 48 (30%)

–

A: 71 (24%) B: 78 (26%)

A: 88 (29%) B: 68 (23%)

–

Among hospitals in both time period: Yes

Adjusted inappropriate continued days of stay

C: 0.0656

D: 0.0617

C: 0.0665

D: 0.0906

–

A: 0.1597

B: 0.1224

A: 0.0770

B: 0.0918

–

B: Yes

A,C,D: No

30-day readmission (rate per 1000 discharge)

C: 105

D: 92

C: 96 D: 76

–

A: 83 B: 73

A: 71

B: 60

–

A,B,D: Yes

C:No

Styrborn [76]

(1995) Sweden

Discharge planning

Adjusted LOS

–

B: 10.5

C: 10.9

–

–

A: 9.6

A-(B + C): −1.1

No

No. of bed-blocking patients

–

B: 35

C: 35

–

–

A: 31

−4

NR

Waiting days/patient

–

B: 11.3

C: 18.0

–

–

A: 8.2

A-(B + C): −6.4

Yes

Charge days per patient

–

B: 6.2

C: 13.4

–

–

A: 4.2

A-(B + C): −5.6

Yes

Rosenberg et al. [65] (1995) the United States

Utilisation review, second opinion, discharge planning, case management

No. of out-patient procedure

–

913

–

–

789

−124

Yes

No. of inpatient procedure

–

452

–

–

466

14

No

No. of admission per 1000 patients

625.4

641.8

16.4

No

Adjusted LOS

–

5.9

–

–

6.1

0.2

No

Adjusted ALOS, mean

–

5.8

–

–

6.1

0.3

No

Jambunathan et al. [45] (1995) the United States

Case management

No. of case management visits/Adjusted LOS (r-value)

–

–

–

–

.6138

–

Yes

Williams et al. [83] (1994) Australia

Drug utilisation review

No. of patients using benzodiazepines

–

–

–

30 (40%)

15 (20%)

−15 (−20%)

Yes

No. of patients using potentially adverse side-effects drug combinations (%)

–

–

–

21 (28%)

7 (9.3%)

−14 (− 18.7%)

Yes

Wickizer [81]

(1992) the United States

Utilisation review

No. of admissions

–

–

–

–

–

−12%

Yes

Adjusted LOS

–

–

–

–

–

–

No

Hospital routine costs

–

–

–

–

–

−8%

Yes

Hospital ancillary costs

–

–

–

–

–

−9%

Yes

Total medical cost

–

–

–

–

–

− 6%

Yes

Cost savings per employee per year

$115

NR

Woodside et al. [84] (1991) the United States

Utilisation management strategies

Adjusted LOS

–

11.8

–

–

9.1

−23%

NR

Total costs, mean

–

$22,695

–

–

$19,042

−16%

NR

Silver et al. [71]

(1992) the United States

Prospective review

No. of orders cancelled

–

–

–

–

114 (21%)

–

NR

Medical costs

–

–

–

–

–

-$22,000

NR

Fowkes et al. [36]

(1986) the United Kingdom

Utilisation review

No. of X-ray tests per100 operations

–

–

–

29.4

13.3

−16.1

Yes

Echols et al. [32]

(1984) the United States

Drug utilisation review

No. of antibiotic treatment courses

–

–

–

–

–

−30%

Yes

No. of patients receiving any antibiotic

–

–

–

47%

30%

−17%

Yes

Restuccia [63]

(1982) the United States

Utilisation review

No. of inappropriate days, mean

–

D: 3.25

–

–

A: 2.59

B: 2.75

C: 3.25

A-D: −0.66

B-D: −0.5

C-D: 0

Yes

Adjusted LOS, mean

–

D: 14.59

–

–

A: 12.23

B: 13.81

C: 15.23

A-D: −2.36

B-D: −0.78

C-D: 0.64

Yes

Murphy [56] (2014) the United

States

Case management

No. of ED visits

–

–

–

7

2

−5

Yes

No. of out-patient visits

–

–

–

7

2

−5

Yes

Direct treatment costs

–

–

–

$2328

$1043

-$1285

Yes

Direct treatment cost per visit

–

–

–

$323

$235

-$88

Yes

Net income

–

–

–

-$608

-$177

$431

Yes

Chiang et al. [27]

(2014) Taiwan

Case management

No. of ED visits, mean

–

–

–

63

26

−37 (−58%)

Yes

Pillow et al. [60]

(2013) the United States

Care plans

No. of ED visits per year per patient

–

–

–

22.6

21.2

−1.4

Yes

No. of admissions per year per patient

–

–

–

7.3

6.8

−0.5

No

Dehaven et al. [31] (2012) the United States

Community-based partnership

No. of ED visits, mean

–

1.44

–

–

0.93

–

Yes

No. of hospital days, mean

–

1.07

–

–

0.37

–

Yes

Direct hospital costs, mean

–

$1188

–

–

$445.6

−62%

Yes

Indirect costs, mean

–

$692.1

–

–

$313.3

−55%

Yes

Tadros et al. [78]

(2012) the United States

Case management

No. of EMS visits, median

–

–

–

8

4

−4

Yes

Total no. of EMS visits

–

–

–

736

459

−37.6%

Yes

No. of ED visits, median

–

–

–

1

0

−1

No

Total no. of ED visits

–

–

–

199

143

−28.1%

No

No. of admissions, median

–

–

–

0

0

0

No

Total no. of admissions

–

–

–

33

30

−9.1%

No

LOS, median

–

–

–

0

0

0

No

LOS, days

–

–

–

122

88

−27.9%

No

EMS costs

–

–

–

$689,743

$468,394

−32.1%

Yes

Out-patient costs

–

–

–

$413,410

$360,779

−12.7

No

Inpatient costs

–

–

–

$687,306

$646,881

−5.9%

No

Total costs

–

–

–

$1,790,459

$1,476,053

-$314,406

(−17.6%)

NR

Shah et al. [68]

(2011) the United States

Care management

No. of ED visits per year, median

–

–

–

6.0

1.7

−3.9

Yes

No. of admissions, median

–

–

–

0.0

0.0

0.0

No

Unadjusted ED cost per patient per year, mean

–

–

–

$2545

$1874

-$671

(−26%)

Yes

Unadjusted admission cost per patient per year, mean

–

–

–

$ 20,298

$ 7053

-$ 13,245

(−65%)

Yes

Stokes-Buzzelli S et al. [75] (2010) the United States

Health Information Technologies

No. of ED visits, mean

–

–

–

67.4

50.5

−16.9

(−%25)

Yes

ED LOS, min

–

–

–

388

342

−46 (−%12)

No

Lab studies ordered, mean

–

–

–

1847

1328

−519 (−%28)

Yes

ED charges

–

–

–

$64,721

$49,208

−15,513

(−24%)

Yes

Total Emergency Department Contact Time, hours

–

–

–

443.7

270.6

− 173.1 or 7.21 days

(−39%)

Yes

Grimmer-

Somers et al. [38] (2010) Australia

Individualised care

plan

No. of ED visits

–

–

–

0.81

0.59

NR

No. of admissions

–

–

–

0.32

0.21

NR

LOS

–

–

–

–

–

−1.3

NR

Grover et al. [39]

(2010) the United States

Case management

No. of ED visits, mean

–

–

–

13.8

3.6

−74%

Yes

No. of CT images

–

–

–

153.6

61.2

−60%

Yes

Skinner et al. [72] (2009) the United Kingdom

Case management

No. of ED visits, median

–

–

–

12

6

−6

Yes

Total no. of ED visits

–

–

–

720

499

− 221 (−31%)

Yes

Shumway et al. [70] (2008) the United States

Case management

No. of ED visits, mean

5.2

2.0

3.6

0.9

Yes

No. of admissions, mean

0.9

0.3

0.8

0.3

No

Medical inpatient days, mean

3.4

1.7

3.4

1.3

No

No. of outpatient visits, mean

2.5

2.6

2.7

2.2

No

ED costs, mean

942

647

790

247

Yes

All hospital costs, mean

8423

3849

8508

4761

No

Homeless, n (%)

32 (80)

11 (33)

61 (76)

22 (32)

Yes

Problem alcohol use, n (%)

21 (53)

12 (30)

38 (48)

22 (28)

Yes

No. of health insurance (%)

31 (78)

17 (53)

59 (75)

30 (44)

Yes

No. of social security income (%)

29 (74)

18 (58)

63 (79)

26 (43)

Yes

Basic financial needs, mean

4.4

3.7

5.2

3.8

Yes

Psychiatric symptoms (total BSI score), mean

10.0

9.8

11.6

10.4

No

Pope et al. [61] (2000) Canada

Case management

No. of number of ED visits, median

–

–

–

26.5

6.5

−20

Yes

Total no. of ED visits

–

–

–

616

175

− 441 (−72%)

Yes

Moher et al. [55] (1992) Canada

Discharge planning

LOS, mean

–

9.4

–

–

7.43

−1.97

Yes

Readmission rate at 2 weeks

–

18 (14%)

–

–

22 (16%)

No

Kennedy et al. [47] (1987) the United States

Discharge planning

LOS, mean

–

9.7

–

–

7.8

−1.9

Yes

Readmission rate at 8 weeks

–

14 (34%)

–

–

11 (28%)

−6%

NR

Kurant et al .[51] (2018) the United States

Laboratory-based utilisation management programs

Copeland et al. [28] (2017) the United States

Modelling

Total imaging per patient

–

–

–

–

–

–

RRs 1.93; 95% CI 1.67–2.23

Pena et al .[58]

(2014) the United States

Blood management program, benchmarking

Total RBC transfusions

–

–

–

37,167

34,602

Yes

Total plasma transfusions

–

–

–

–

10,544

NR

Total platelets transfusions

–

–

–

8202

7844

NR

Total albumin transfusions

–

–

–

23,949

24,557

NR

Total IVIg transfusions

–

–

–

52,085

44,973

Weilburg et al. [80] (2017) the United States

Analysis of high-cost imaging utilisation

No. of high-cost imaging per year

–

–

–

0.43 examinations

0.34 examinations

- 21.3%

Yes

Overall laboratory utilisation

–

–

–

–

–

−9.4%

Yes

Inpatient stays

–

–

–

0.453

0.422

No

No. of departments visited

–

–

–

0.558

0.823

Yes

Konger et al. [50]

(2016) the United States

Reductions in unnecessary clinical laboratory testing

Total test volume per year

–

–

–

–

–

−11.18%

Yes

El-Othmani

et al. [33] (2019) the United States

Joint utilisation management program

LOS

9.27

6.2

4.22

3.04

The rate of 30 day readmission

21.05

23.50

9.94

8.0

Inpatient rehabilitation

15.79

5.88

5.9

3.08

Kim & Lee [48] (2020) Korea

Case Management

Inpatient days

30.5

10.6

Outpatient visits

128.3

104.7

Self-care ability

15.41

18.64

Wasfy et al. [79] (2019) the United States

Hospital Readmissions reduction Program

In-patient readmission

0.023

0.002

yes

Treat-and-discharge visit to emergency department

0.014

0.029

yes

Observation stay (not leading to inpatient readmission)

0.019

0.024

yes

Calsolaro et al. [25] (2019)

Hospital Readmissions Reduction Program

Potentially preventable read-missions (PPR)

LOS (median and range)

5 (4-6)

6 (2-14)