The study was conducted in four EDs affiliated with the Estrie Integrated University Health and Social Services Centre (IUHSSC) and the Saguenay-Lac-Saint-Jean IUHSSC, in two Quebec (Canada) regions. The four EDs are located in three urban areas [35], with a population of respectively 26,669, 145,949 and 161,323 inhabitants in 2016 [36]. Participants were identified at their third or more visit to the ED within 12 months. This cut-off was chosen to increase prevalence of complexity in the sample and avoid screening patients with low risk of complexity. They were approached to participate if they were adults (≥ 18 years), had three or more visits to the ED within 12 months and presented at least one ACSC (angina, asthma, chronic obstructive pulmonary disease, diabetes, grand mal status and other epileptic convulsions, heart failure and pulmonary edema, or hypertension). They were excluded if they had a critical situation requiring urgent care or if they had already participated in this study because of a previous ED visit during the data collection period.

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