Transfer from residential aged care to emergency departments: an analysis of patient outcomes

Authors

  • G. Arendts,

    Corresponding author
    1. Sydney School of Public Health, University of Sydney, Sydney, New South Wales
    2. Centre for Clinical Research in Emergency Medicine, Western Australian Institute for Medical Research, Perth, Western Australia
    3. Discipline of Emergency Medicine, University of Western Australia, Royal Perth Hospital, Perth, Western Australia
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  • C. Dickson,

    1. Central Hospitals Network, South Eastern Sydney and Illawarra Area Health Service, Sydney, New South Wales, Australia
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  • K. Howard,

    1. Sydney School of Public Health, University of Sydney, Sydney, New South Wales
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  • S. Quine

    1. Sydney School of Public Health, University of Sydney, Sydney, New South Wales
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  • Funding: None.

  • Conflict of interest: None.

Glenn Arendts, Emergency Medicine, Royal Perth Hospital, GPO Box X2213, Perth, WA 6001, Australia. Email: glenn.arendts@uwa.edu.au

Abstract

Background: In order to design optimal systems to meet the acute healthcare needs of the frail elderly living in residential care, good clinical information is essential. The aims of this study were to analyse the casemix and outcomes of patients transferred from residential aged care facilities to public hospital emergency departments in New South Wales.

Methods: Individual patient data from six hospital emergency departments and inpatient wards were obtained from merged databases and analysed using descriptive and comparative statistics.

Results: Outcomes in 4680 patient transfers over a 12-month period in 2006–2007 were analysed. Transfers occur mostly in high-acuity patients, with approximately three of every four transfers admitted; one in every 12 dying; and admitted patients undergoing an average of 2.4 interventions or procedures during each hospital stay. Several variables are associated with prolonged length of emergency department stay including triage urgency, type of hospital and transfers occurring in winter or out of hours.

Conclusions: Patients transferred from aged care facilities to emergency departments are predominantly high-acuity patients with a substantial likelihood of hospitalisation, intervention and death. Nevertheless, scope exists for some episodes of acute care, in both discharged and admitted patients, to be provided outside a hospital setting.

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