Altena, Nynke (2020) Prevalentie, kenmerken en uitkomsten van voorkombare verwijzingen van ouderen naar de SEH: een observationele studie. thesis, Medicine.
Full text available on request.Abstract
Background Preventable admissions to the emergency department (ED) lead to ED crowding, which is related to complications and a decreased quality of care. Elderly patients (aged ≥65 years old) are more at risk of complications. Aim To examine the prevalence, characteristics and follow-up of potentially preventable admissions of elderly patients, who were autonomously referred by emergency medical services (EMS) after a 911 call. As evaluation for a possible intervention against ED crowding. Methods An observational cross-sectional study was conducted. Data was collected in the EDs of 3 hospitals in the north of the Netherlands. The treating ED physician assessed the preventability of the admissions. Results There were 291 ED visits of elderly, 96 visits were included and analyzed. Overall, 17% was potentially preventable. Preventable admissions were more often non-traumatic diagnoses in combination with a shorter distance to ED (p=0,008) or with a 911 call via the general practitioner (GP) without the GP having been there (p=0,0047). They were more often not admitted (p<0,001), readmitted (p=0,017) and there was more often no treatment at ED (p=0,005). There were no differences in other patient outcomes or characteristics. Conclusion Preventable admissions were more often a 911 call via the GP, without the GP having been there in combination with non-traumatic diagnoses or a shorter distance to ED. Therefore, intervention of the GP in these groups and communication between primary care, secondary care and EMS could potentially decrease the prevalence of preventable admissions.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Lameijer, dr. H. |
| Faculty: | Medical Sciences |
| Date Deposited: | 31 Jul 2023 11:29 |
| Last Modified: | 31 Jul 2023 11:29 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3605 |
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