All ETDs from UAB


Michael Malaise

Advisory Committee Chair

Stephen J O'Connor

Advisory Committee Members

Nathan Carroll

Larry Hearld

S Robert Hernandez

Document Type


Date of Award


Degree Name by School

Executive Doctor of Science (DSc) School of Health Professions


is study examined whether a case management model designed to reduce emergency department utilization among patients described as super-utilizers in a public health system could also reduce the per patient cost of those super-utilizers. The setting for this study was a large public health system in a major metropolitan area. The study focused on a low-income, urban population. Given the program’s stated desire to improve the self-efficacy of patients over time so that they could take more ownership of their own health status, this study reviewed the program within the framework of self-efficacy theory. This research predicted that the case management program in question would lead to reductions in both per patient cost as well as emergency department utilization over a six-month period. The findings from the study were unable to substantiate research predictions for either per patient cost or emergency department utilization. Statistical analysis found no significant difference in either cost or utilization between a test group enrolled in the case management program and a control group.