Capturing Emergency Department Discharge Quality With the Care Transitions Measure: A Pilot Study

被引:15
作者
Sabbatini, Amber K. [1 ,4 ]
Gallahue, Fiona [1 ]
Newson, Joshua [2 ]
White, Stephanie [2 ]
Gallagher, Thomas H. [3 ,4 ]
机构
[1] Univ Washington, Dept Emergency Med, Seattle, WA 98195 USA
[2] Univ Washington, Sch Med, Seattle, WA USA
[3] Univ Washington, Dept Med, Seattle, WA USA
[4] Univ Washington, Ctr Scholarship Patient Care Qual & Safety, Seattle, WA 98195 USA
关键词
SELF-RATED HEALTH; ACCESS;
D O I
10.1111/acem.13623
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background Recent attention has been given to developing measures to capture the quality of ED transitions of care. We examined the utility of a patient-reported measure of transitional care, the Care Transitions Measure-3 (CTM-3), in the ED setting and its association with outcomes of care after ED discharge. Methods A telephone survey was conducted of a convenience sample of patients 14 days after discharge from two emergency departments (EDs) in an academic health system. Patients responded to three statements using a four-point agreement scale (strongly disagree, disagree, agree, strongly agree): 1) "The hospital staff took my preferences and those of my family or caregiver into account when deciding what my health care needs would be"; 2) " When I left the ER, I had a good understanding of the things I was responsible for in managing my health"; and 3) "When I left the hospital, I clearly understood the purpose for taking each of my medications." Patients were also queried about outcomes after ED discharge that are known to be related to ED care transitions including medication adherence, completion of recommended follow-up, and return visits to the ED. Multivariable logistic regression was used to determine the association between the CTM-3 score (on a 100-point scale) and outcomes of interest. Results Among 1,832 patients called, 576 were reached by phone, and 410 consented and completed our survey, representing a 22.4% response rate of patients we attempted to call. A 10-point increase in the CTM-3 score (better care experiences) was associated with a 12% decrease in the odds of having an ED return visit (adjusted odds ratio [AOR] = 0.88, 95% confidence interval [CI] = 0.77-1.00) and a 45% increase in the odds of taking prescribed medications as recommended (AOR = 1.45, 95% CI = 1.12-1.87). There was no association between CTM-3 score and completion of follow-up. Conclusions The CTM-3 is associated with outcomes of care after an ED visit, including ED return visits and medication adherence, and may have utility as a patient-reported measure of ED transitions of care.
引用
收藏
页码:605 / 609
页数:5
相关论文
共 24 条
  • [1] Psychometric Evaluation of the Care Transition Measure in TRACE-CORE: Do We Need a Better Measure?
    Anatchkova, Milena D.
    Barysauskas, Constance M.
    Kinney, Rebecca L.
    Kiefe, Catarina I.
    Ash, Arlene S.
    Lombardini, Lisa
    Allison, Jeroan J.
    [J]. JOURNAL OF THE AMERICAN HEART ASSOCIATION, 2014, 3 (03):
  • [2] Insurance status and access to urgent ambulatory care follow-up appointments
    Asplin, BR
    Rhodes, KV
    Levy, H
    Lurie, N
    Crain, AL
    Carlin, BP
    Kellermann, AL
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2005, 294 (10): : 1248 - 1254
  • [3] Braithwaite Sabina A, 2011, Acad Emerg Med, V18, pe39, DOI 10.1111/j.1553-2712.2011.01080.x
  • [4] Carpenter CR, 2011, ACAD EMERG MED, V18, P782, DOI [10.1111/j.1553-2712.2011.01121.x, 10.1111/j.1553-2712.2011.01096.x]
  • [5] Assessing the quality of preparation for posthospital care from the patient's perspective - The care transitions measure
    Coleman, EA
    Mahoney, E
    Parry, C
    [J]. MEDICAL CARE, 2005, 43 (03) : 246 - 255
  • [6] Coleman Eric A, 2007, Home Health Care Serv Q, V26, P93, DOI 10.1300/J027v26n04_07
  • [7] Mortality prediction with a single general self-rated health question
    DeSalvo, KB
    Bloser, N
    Reynolds, K
    He, J
    Muntner, P
    [J]. JOURNAL OF GENERAL INTERNAL MEDICINE, 2006, 21 (03) : 267 - 275
  • [8] Is the Care Transitions Measure Associated with Readmission Risk? Analysis from a Single Academic Center
    Goldstein, Jennifer N.
    Hicks, LeRoi S.
    Kolm, Paul
    Weintraub, William S.
    Elliott, Daniel J.
    [J]. JOURNAL OF GENERAL INTERNAL MEDICINE, 2016, 31 (07) : 732 - 738
  • [9] Adverse health outcomes after discharge from the emergency department-incidence and risk factors in a veteran population
    Hastings, S. Nicole
    Schmader, Kenneth E.
    Sloane, Richard J.
    Weinberger, Morris
    Goldberg, Kenneth C.
    Oddone, Eugene Z.
    [J]. JOURNAL OF GENERAL INTERNAL MEDICINE, 2007, 22 (11) : 1527 - 1531
  • [10] Continuity of primary care and emergency department utilization among elderly people
    Ionescu-Ittu, Raluca
    McCusker, Jane
    Ciampi, Antonio
    Vadeboncoeur, Alain-Michel
    Roberge, Daniele
    Larouche, Danielle
    Verdon, Josee
    Pineault, Raynald
    [J]. CANADIAN MEDICAL ASSOCIATION JOURNAL, 2007, 177 (11) : 1362 - 1368