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Reducing emergency department visits among high-using patients.

Intervention using a real-time database system was accepted by physicians and reduced high-cost encounters. The risk of a high-cost encounter was significantly greater for the minimal intervention than for the moderate or maximal intervention groups. The probability of an emergency department visit was significantly reduced for minimal compared with moderate and maximal intervention. The risk for emergency department events was the same for the moderate and maximal intervention groups. Moderate intervention seems the most cost-effective because of reductions achieved with minimal staff involvement.