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01.12.2014 | Original Research | Ausgabe 1/2014 Open Access

International Journal of Emergency Medicine 1/2014

The emergency to home project: impact of an emergency department care coordinator on hospital admission and emergency department utilization among seniors

Zeitschrift:
International Journal of Emergency Medicine > Ausgabe 1/2014
Autoren:
Christopher Matthew Bond, Elizabeth A Freiheit, Lesley Podruzny, Alianu Akawakun Kingsly, Dongmei Wang, Jamie Davenport, Abram Gutscher, Cathy Askin, Allison Taylor, Vivian Lee, Queenie Choo, Eddy Samuel Lang
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1865-1380-7-18) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

EAF, KAA, DW, and VL performed statistical analysis of the data. CA, JD, VL, and AT gathered the data, performed data linkage and created the dashboards for analysis. AT, JD, and QC were responsible for the Emergency to Home Project leadership and oversight. CMB, EL, AT, JD, VL, and QC conceived the study design. CMB drafted the manuscript, all other authors contributed to revisions for the final submission. All authors read and approved the final manuscript.

Abstract

Background

Seniors comprise 14% to 21% of all emergency department (ED) visits, yet are disproportionately larger users of ED and inpatient resources. ED care coordinators (EDCCs) target seniors at risk for functional decline and connect them to home care and other community services in hopes of avoiding hospitalization.
The goal of this study was to measure the association between the presence of EDCCs and admission rates for seniors aged ≥ 65. Secondary outcomes included length of stay, recidivism at 30 days, and revisit resulting in admission at 30 days.

Methods

This was a matched pairs study using administrative data from eight EDs in six Alberta cities. Four of these hospitals were intervention sites, in which patients were seen by an EDCC, while the other four sites had no EDCC presence. All seniors aged ≥ 65 with a discharge diagnosis of fall or musculoskeletal pathology were included. Cases were matched by CTAS category, age, gender, mode of arrival, and home living environment. McNemar’s test for matched pairs was used to compare admission and recidivism rates at EDCC and non-EDCC hospitals. A paired t-test was used to compare length of stay between groups.

Results

There were no statistically significant differences for baseline admission rate, revisit rate at 30 days, and readmission rate at 30 days between EDCC and non-EDCC patients.

Conclusions

This study showed no reduction in senior patients’ admission rates, recidivism at 30 days, or hospital length of stay when comparing seniors seen by an EDCC with those not seen by an EDCC.
Zusatzmaterial
Authors’ original file for figure 1
12245_2013_180_MOESM1_ESM.tiff
Literatur
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