Study Objective: Elderly emergency department patients have complex medical needs and limited social support. A transitional model of care adapted from hospitals was tested for its effectiveness in the ED in reducing subsequent service use.
Methods: A randomized clinical trial was conducted at 2 urban, academically affiliated hospitals. Participants were 650 community-residing individuals 65 years or older who were discharged home after an ED visit. Main outcomes were service use rates, defined as repeat ED visits, hospitalizations, or nursing home admissions, and health care costs at 30 and 120 days. Intervention consisted of comprehensive geriatric assessment in the ED by an advanced practice nurse and subsequent referral to a community or social agency, primary care provider, and/or geriatric clinic for unmet health, social, and medical needs. Control group participants received usual and customary ED care.
Results: The intervention had no effect on overall service use rates at 30 or 120 days. However, the intervention was effective in lowering nursing home admissions at 30 days (0.7% versus 3%; odds ratio 0.21; 95% confidence interval [CI] 0.05 to 0.99) and in increasing patient satisfaction with ED discharge care (3.41 versus 3.03; mean difference 0.37; 95% CI 0.13 to 0.62). The intervention was more effective for high-risk than low-risk elders.
Conclusion: An ED-based transitional model of care reduced subsequent nursing home admissions but did not decrease overall service use for older ED patients. Further studies are needed to determine the best models of care for this setting and for at-risk patients.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1067/mem.2003.3 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Acute gastrointestinal and post-acute COVID-19 gastrointestinal syndrome assessment on the Gastrointestinal Symptom Rating Scale scoring system: A questionnaire-based survey.
J Family Med Prim Care
December 2024
Nursing Tutor, Vardhman Mahaveer Nursing Medical College, New Delhi, India.
Background: Post-acute coronavirus disease 2019 (COVID-19) syndrome (PACS) is the persistence of sequel of acute SARS-COV-2 infection. Persistent/acquired gastrointestinal symptoms (GI-PACS) include loss of appetite, nausea, weight loss, abdominal pain, heartburn, dysphagia, altered bowel motility, dyspepsia, and irritable bowel syndrome. The study aimed to assess the short- and long-term GI-PACS syndrome on the GSRS scale.
View Article and Find Full Text PDFAssessing neonatal nurses: transitioning preterm infants to oral feeding - a multicenter cross-sectional study.
BMC Nurs
January 2025
Department of Nursing Administration and Education, College of Nursing, Taibah University, Medina, Saudi Arabia.
Background: In Egypt, approximately 10% of preterm deliveries occur between 32 and fewer than 37 weeks, leading to high neonatal intensive care unit (NICU) admissions. Preterm infants often face oral feeding difficulties due to immature development, which can lead to extended hospital stays and increased health risks.
Aim: To assess neonatal nurses' performance in terms of the transition to oral feeding in preterm infants, focusing on knowledge, practices, and attitudes.
Evaluation of COVID-19 Diagnosis Codes for Identification of SARS-CoV-2 Infections in a Nursing Home Cohort, 2022-2023.
J Am Med Dir Assoc
January 2025
Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Objectives: This study aimed to evaluate the utility of electronic health record (EHR) diagnosis codes for monitoring SARS-CoV-2 infections among nursing home residents.
Design: A retrospective cohort study design was used to analyze data collected from nursing homes operating under the tradename Signature Healthcare between January 2022 and June 2023.
Setting And Participants: Data from 31,136 nursing home residents across 76 facilities in Kentucky, Tennessee, Indiana, Ohio, North Carolina, Georgia, Alabama, and Virginia were included.
The impact of new-onset atrial fibrillation in the setting of acute coronary syndrome.
J Cardiol
January 2025
Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China; Kent and Medway Medical School, Canterbury, Kent, UK; School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China.
Approximately 10 % of patients who have suffered from myocardial infarction develop new-onset atrial fibrillation (AF). Coronary artery disease implicating atrial branches has been associated with AF. The following variables have been associated with new-onset AF in the setting of acute coronary syndrome: older age, history of hypertension, history of angina, history of stroke, chronic renal failure, body mass index, no statin use, worse nutritional status, worse Killip class, admission heart rate ≥ 85 bpm, complete atrioventricular block, Glasgow prognostic score, Syntax score, CHEST score > 3, PRECISE-DAPT score ≥ 25, left ventricular ejection fraction ≤40 %, increased left atrial diameter, E/E' ratio > 12, epicardial fat tissue thickness, and thrombolysis in myocardial infarction flow <3.
View Article and Find Full Text PDFMuscle strength trajectories and outcomes in critically ill patients: A prospective multicentre cohort study.
Intensive Crit Care Nurs
January 2025
School of Nursing, Fujian Medical University, Fuzhou, China. Electronic address:
Objectives: To investigate the trajectories and determinants of muscle strength in ICU patients and their impact on 1-, 6-, and 12-month mortality outcomes.
Design: Prospective multicenter cohort study.
Settings: Ten ICUs across five tertiary hospitals in Fujian Province, China.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!