Karimi, Nilofar (2020) Potentially preventable admissions of elderly to the Emergency Department: differences in routes of admission? thesis, Medicine.
Full text available on request.Abstract
Background: Preventable admissions of elderly to the Emergency department (ED) have been related to negative patient related outcomes. However, research on the incidence of preventable admissions and potential differences in route of referral is scarce. Therefore we aimed to investigate the incidence of preventable admissions of elderly aged ≥65 years who were either referred by a general practitioner (GP) and conveyed by Emergency medical services (EMS) or who were referred independently by EMS to the ED. Additionally, we aimed to evaluate potential differences in route of referral. Methods: An observational cross-sectional study was conducted at the ED of 4 hospitals in the Netherlands. Preventability of an admission was assessed by the treating physician through the use of questionnaires. Results: A total of 293 patients were included, out of which 16% (n=47) was identified as preventable. Nineteen percent (n=27) of the patients referred by a GP and 13% (n=20) of the patients referred by EMS were classified as preventable, with no significant difference between the two routes (p=0.198). Significant difference were found between the GP and EMS regarding residence, ambulance urgency ride, multi-morbidity, advanced directive, length of stay in ED and type of intervention. A short distance to the ED was associated with a higher preventability. Conclusion: Approximately 16% of the admissions to the ED are potentially preventable when assessed by the treating physician, without a difference in route of admission. Future studies should be focusing on the reduction of potentially preventable visits, particularly the visits that come from nearby the ED.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Dr. Lameijer MSc MD PhD, H. |
| Faculty: | Medical Sciences |
| Date Deposited: | 29 Nov 2023 12:29 |
| Last Modified: | 29 Nov 2023 12:29 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3728 |
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