05 Using case management to remove burden on emergency departements


Most emergency departments (ED) in Switzerland are overloaded. This is explained in part by some patients making above-average use of EDs. Introducing a type of case management response should help improve this situation.

Portrait / project description (ongoing research project)

Case management focuses on patients who are frequent users of emergency departments and who go there at least five times a year. Case management will be carried out at three different levels depending on the hospital: the first group of hospitals will benefit from strong case management type support as practiced in Lausanne, the second from less intensive support and the third will continue current practice. The introduction of case management will be re-evaluated in the three cases in terms of the number of visits to the emergency department and use of social/medical services, the quality of life of the persons tracked by the case management teams and the costs associated with these different interventions.


Emergency department services in Switzerland are overused by a small group of patients. At Lausanne University Hospital, this group, while representing just 4% of total patients, generates 12% of consultations. Often these are of a socio-economically complex nature and associated with chronic illnesses or addiction-related mental illnesses. Studies carried out to date show that initiating a case management type response for frequent users of emergency room services can help reduce the workload of the emergency department.


This study aims to introduce a case management system for frequent users of emergency departments in different emergency organisations. The goal is to introduce this system gradually in different hospitals in French-speaking Switzerland in order to study its implementation and effects.

Relevance / Application

A model has been developed to avoid excessive use of emergency departments in Switzerland and allow regular users who suffer from complex medical problems to be directed towards more specialist services. This model can be applied to all emergency departments in Switzerland, thereby reducing their workload.

Original title

Implementing a case management intervention for frequent users of the emergency department: a multicenter study in Switzerland (I-CaM)

Project leaders


  • Prof. Patrick Bodenmann, Centre des populations vulnérables (CPV), Université de Lausanne


  • Dr. Judith Griffin, Policlinique Médicale Universitaire, Université de Lausanne
  • Dr. Olivier Hugli, Centre interdisciplinaire des urgences, Université de Lausanne
  • Prof. Jean-Bernard Daeppen, Centre de Traitement en Alcoologie, Centre Hospitalier Universitaire Vaudois (CHUV)

Project partners:

  • Dr. Joanna Moullin, Child & Adolescent Services Research Center Department, Psychiatry University of California, San Diego
  • Dr. Donna Zulman, Division of General Medical Discipline, Department of Medicine, Stanford University



Further information on this content


Prof. Patrick Bodenmann Titulaire de la Chaire de médecine des populations vulnérables UNIL
Université de Lausanne Médecin adjoint, responsable du Centre des populations vulnérables (CPV) PMU
Policlinique médicale universitaire
Rue du Bugnon 44
Bureau BU44/06/2202
1011 Lausanne +41 21 314 49 37

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