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Continuity of Care in Emergency Department and Elderly | Abstract
Emergency Medicine: Open Access

Emergency Medicine: Open Access
Open Access

ISSN: 2165-7548

Abstract

Continuity of Care in Emergency Department and Elderly

Gonçalo S, Fatima Leal-Seabra, Rafaela V and Agripino O

Background: Numerous studies have suggested that better continuity of care (COC) can lead to fewer emergency department (ED) visits. The loss of information is a constant demand for unnecessary services. This study aimed to determine the patterns of informational COC in ED utilization and increased health care utilization may be apparent in a health care system that lacks a referral system. Materials and methods: In a study conducted in November 2015 were evaluated episodes of ED, setting as lack of continuity of care episodes with discharged to home. The variables analyzed were: sex, age, the color of Manchester Triage (MTS), COC, diagnosis by ICD9, destination, and readmission. We used descriptive statistics and chi-square were used for a p-value <0.05. Results: The number of older episodes was 34% (2729/8037). The most common profile was women with 54 years old, which diagnosis was injury and poisoning, screened with yellow color and discharged to home. COC represented 56.9% of the episodes. The readmission to the ED was 12.8%. Determinants associated with episodes without COC were young patients (RR=1.13, CI=1.10 to 1.17), with a low priority of MTS (RR 1.46, 95% CI 1.35-1.57) and no readmission to ED (RR 1.94, 95% CI 1.70-2.21) Conclusions: In conclusion, the ward admission rate of elderly patients who visited the ED was higher than the younger adult patients. Our analysis showed a higher level of continuity with an increased rate of hospitalization, after adjustment for the patient's age group. The determinants associated with episodes without COC were young patients, with a low priority of MTS and no readmission to ED.