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Measuring Potentially Avoidable Acute Care Transfers From Long-Term Care Homes in Quebec: a Cross Sectional Study

BACKGROUND: Potentially avoidable emergency department transfers (PAEDTs) and hospitalizations (PAHs) from long-term care (LTC) homes are two key quality improvement metrics. We aimed to: 1) Measure proportions of PAEDTs and PAHs in a Quebec sample; and 2) Compare them with those reported for the re...

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Autores principales: Cetin-Sahin, Deniz, Karanofsky, Mark, Cummings, Greta G., Vedel, Isabelle, Wilchesky, Machelle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Canadian Geriatrics Society 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10444526/
https://www.ncbi.nlm.nih.gov/pubmed/37662066
http://dx.doi.org/10.5770/cgj.26.620
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author Cetin-Sahin, Deniz
Karanofsky, Mark
Cummings, Greta G.
Vedel, Isabelle
Wilchesky, Machelle
author_facet Cetin-Sahin, Deniz
Karanofsky, Mark
Cummings, Greta G.
Vedel, Isabelle
Wilchesky, Machelle
author_sort Cetin-Sahin, Deniz
collection PubMed
description BACKGROUND: Potentially avoidable emergency department transfers (PAEDTs) and hospitalizations (PAHs) from long-term care (LTC) homes are two key quality improvement metrics. We aimed to: 1) Measure proportions of PAEDTs and PAHs in a Quebec sample; and 2) Compare them with those reported for the rest of Canada. METHODS: We conducted a repeated cross-sectional study of residents who were received at one tertiary hospital between April 2017 and March 2019 from seven LTC homes in Quebec, Canada. The MedUrge emergency department database was used to extract transfers and resident characteristics. Using published definitions, PAEDTs and PAHs were identified from principal emergency department and hospitalization diagnoses, respectively. PAEDT and PAH proportions were compared to those reported by the Canadian Institute for Health Information. RESULTS: A total of 1,233 transfers by 692 residents were recorded, among which 36.3% were classified as being potentially avoidable: 22.8% ‘PAEDT only’, 11.6% ‘both PAEDT & PAH’, and 1.9% ‘PAH only’. Shortness of breath was the most common reason for transfer. Pneumonia was the most common diagnosis from the ‘both PAEDT & PAH’ category. PAEDTs and PAHs accounted for 95% and 37% of potentially avoidable transfers, respectively. Among 533 hospitalizations, 31.3% were PAHs. These proportions were comparable to the rest of Canada, with some differences in proportions of transfers due to congestive heart failure, urinary tract infection, and implanted device management. CONCLUSIONS: PAEDTs far outweigh PAHs in terms of frequency, and their monitoring is important for quality assurance as they may inform LTC-level interventions aimed at their reduction.
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spelling pubmed-104445262023-09-01 Measuring Potentially Avoidable Acute Care Transfers From Long-Term Care Homes in Quebec: a Cross Sectional Study Cetin-Sahin, Deniz Karanofsky, Mark Cummings, Greta G. Vedel, Isabelle Wilchesky, Machelle Can Geriatr J Original Research BACKGROUND: Potentially avoidable emergency department transfers (PAEDTs) and hospitalizations (PAHs) from long-term care (LTC) homes are two key quality improvement metrics. We aimed to: 1) Measure proportions of PAEDTs and PAHs in a Quebec sample; and 2) Compare them with those reported for the rest of Canada. METHODS: We conducted a repeated cross-sectional study of residents who were received at one tertiary hospital between April 2017 and March 2019 from seven LTC homes in Quebec, Canada. The MedUrge emergency department database was used to extract transfers and resident characteristics. Using published definitions, PAEDTs and PAHs were identified from principal emergency department and hospitalization diagnoses, respectively. PAEDT and PAH proportions were compared to those reported by the Canadian Institute for Health Information. RESULTS: A total of 1,233 transfers by 692 residents were recorded, among which 36.3% were classified as being potentially avoidable: 22.8% ‘PAEDT only’, 11.6% ‘both PAEDT & PAH’, and 1.9% ‘PAH only’. Shortness of breath was the most common reason for transfer. Pneumonia was the most common diagnosis from the ‘both PAEDT & PAH’ category. PAEDTs and PAHs accounted for 95% and 37% of potentially avoidable transfers, respectively. Among 533 hospitalizations, 31.3% were PAHs. These proportions were comparable to the rest of Canada, with some differences in proportions of transfers due to congestive heart failure, urinary tract infection, and implanted device management. CONCLUSIONS: PAEDTs far outweigh PAHs in terms of frequency, and their monitoring is important for quality assurance as they may inform LTC-level interventions aimed at their reduction. Canadian Geriatrics Society 2023-09-01 /pmc/articles/PMC10444526/ /pubmed/37662066 http://dx.doi.org/10.5770/cgj.26.620 Text en © 2023 Author(s). https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No-Derivative license (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits unrestricted non-commercial use and distribution, provided the original work is properly cited.
spellingShingle Original Research
Cetin-Sahin, Deniz
Karanofsky, Mark
Cummings, Greta G.
Vedel, Isabelle
Wilchesky, Machelle
Measuring Potentially Avoidable Acute Care Transfers From Long-Term Care Homes in Quebec: a Cross Sectional Study
title Measuring Potentially Avoidable Acute Care Transfers From Long-Term Care Homes in Quebec: a Cross Sectional Study
title_full Measuring Potentially Avoidable Acute Care Transfers From Long-Term Care Homes in Quebec: a Cross Sectional Study
title_fullStr Measuring Potentially Avoidable Acute Care Transfers From Long-Term Care Homes in Quebec: a Cross Sectional Study
title_full_unstemmed Measuring Potentially Avoidable Acute Care Transfers From Long-Term Care Homes in Quebec: a Cross Sectional Study
title_short Measuring Potentially Avoidable Acute Care Transfers From Long-Term Care Homes in Quebec: a Cross Sectional Study
title_sort measuring potentially avoidable acute care transfers from long-term care homes in quebec: a cross sectional study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10444526/
https://www.ncbi.nlm.nih.gov/pubmed/37662066
http://dx.doi.org/10.5770/cgj.26.620
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