Transfers from residential aged care facilities to the emergency department are reduced through improved primary care services: An intervention study

被引：45

作者：

Codde, Jim ^{[3
]}

Arendts, Glenn ^{[1
,2
,6
]}

Frankel, Jackie ^{[4
]}

Ivey, Mary ^{[5
]}

Reibel, Tracy ^{[2
]}

Bowen, Shirley ^{[5
]}

Babich, Paul ^{[4
]}

机构：

[1] Western Australian Inst Med Res, Ctr Clin Res Emergency Med, Perth, WA, Australia

[2] Univ Western Australia, Sch Primary Aboriginal & Rural Hlth Care, Perth, WA 6009, Australia

[3] S Metropolitan Area Hlth Serv, Perth, WA, Australia

[4] Fremantle GP Network, Fremantle, WA, Australia

[5] Fremantle Hosp & Hlth Serv, Fremantle, WA, Australia

[6] Royal Perth Hosp, Discipline Emergency Med, Perth, WA, Australia

来源：

AUSTRALASIAN JOURNAL ON AGEING | 2010年 / 29卷 / 04期

关键词：

emergency department; frail older people; nursing homes; primary care; NURSING-HOME; PATIENT TRANSFER; HOSPITALIZATION; ROOM;

D O I：

10.1111/j.1741-6612.2010.00418.x

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

Aim: To assess the impact of an enhanced primary care service for residential aged care facilities (RACF) on the transfer of patients from RACF to a hospital emergency department (ED). Methods: A before-after study of an enhanced primary care service provided by experienced ED-based nurses under the governance of general practitioners. The intervention was analysed comparatively using standardised normal deviates and seasonal autoregressive integrated moving average models, complemented by qualitative assessment. Results: There was a statistically significant reduction (17%, P < 0.001) in the number of transfers during the intervention period. This finding held when adjusting for the seasonality of ED referrals over a 4-year period. The intervention was highly valued by clinicians in RACF and ED. Conclusion: Enhanced primary care services reduce the number of transfers to ED from RACF.

引用

页码：150 / 154

页数：5

共 18 条

[1]

Aigner Mary J, 2004, J Am Med Dir Assoc, V5, P16, DOI 10.1016/S1525-8610(04)70039-0

[2] Can transfers from residential aged care facilities to the Emergency Department be avoided through improved primary care services? Data from qualitative interviews [J].

Arendts, Glenn ;

Reibel, Tracy ;

Codde, Jim ;

Frankel, Jackie .

AUSTRALASIAN JOURNAL ON AGEING, 2010, 29 (02) :61-65

[3] APPROPRIATENESS OF PATIENT TRANSFER FROM A NURSING-HOME TO AN ACUTE-CARE HOSPITAL - A STUDY OF EMERGENCY ROOM VISITS AND HOSPITAL ADMISSIONS [J].

BERGMAN, H ;

CLARFIELD, AM .

JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 1991, 39 (12) :1164-1168

[4] Geriatric nurse practitioners in long-term care: Demonstration of effectiveness in managed care [J].

Burl, JB ;

Bonner, A ;

Rao, M ;

Khan, AM .

JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 1998, 46 (04) :506-510

[5] Advance care planning and hospital in the nursing home [J].

Caplan, Gideon A. ;

Meller, Anne ;

Squires, Barbara ;

Chan, Stella ;

Willett, Wendy .

AGE AND AGEING, 2006, 35 (06) :581-585

[6] HAZARDS OF HOSPITALIZATION OF THE ELDERLY [J].

CREDITOR, MC .

ANNALS OF INTERNAL MEDICINE, 1993, 118 (03) :219-223

[7]

Dosa David, 2005, J Am Med Dir Assoc, V6, P327, DOI 10.1016/j.jamda.2005.06.005

[8] The geriatric emergency department [J].

Hwang, Ula ;

Morrison, Sean .

JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2007, 55 (11) :1873-1876

[9] Patient transfer from nursing home to emergency department: Outcomes and policy implications [J].

Jones, JS ;

Dwyer, PR ;

White, LJ ;

Firman, R .

ACADEMIC EMERGENCY MEDICINE, 1997, 4 (09) :908-915

[10] The effect of evercare on hospital use [J].

Kane, RL ;

Keckhafer, G ;

Flood, S ;

Bershadsky, B ;

Siadaty, MS .

JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2003, 51 (10) :1427-1434

← 1 2 →