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Evaluation of the Detection of Elder Mistreatment Through Emergency Care Technicians Project Screening Tool
IMPORTANCE: Elder mistreatment is underdetected and underreported. The more than 800 000 medics providing services in every county in the United States represent an important and underused surveillance system. OBJECTIVE: To investigate the association between the Detection of Elder Mistreatment Thro...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Medical Association
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7206507/ https://www.ncbi.nlm.nih.gov/pubmed/32379330 http://dx.doi.org/10.1001/jamanetworkopen.2020.4099 |
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author | Cannell, Brad Livingston, Melvin Burnett, Jason Parayil, Megin Reingle Gonzalez, Jennifer M. |
author_facet | Cannell, Brad Livingston, Melvin Burnett, Jason Parayil, Megin Reingle Gonzalez, Jennifer M. |
author_sort | Cannell, Brad |
collection | PubMed |
description | IMPORTANCE: Elder mistreatment is underdetected and underreported. The more than 800 000 medics providing services in every county in the United States represent an important and underused surveillance system. OBJECTIVE: To investigate the association between the Detection of Elder Mistreatment Through Emergency Care Technician (DETECT) screening tool use and the number of medic reports made to Adult Protective Services (APS) over a period of approximately 3 years. DESIGN, SETTING, AND PARTICIPANTS: This quality improvement study used a difference in difference in differences design and included adults aged 65 years and older who were reported to Texas APS in the study region (246 cities in Denton, Johnson, and Tarrant Counties) between December 31, 2014, and February 28, 2018. EXPOSURES: The DETECT screening tool. MAIN OUTCOMES AND MEASURES: Reports to APS. RESULTS: The mean (SD) age of the 11 178 older adults included in this study was 76 (8) years (range, 65-105 years); there was no reported data on patient sex. A total of 18 080 reports of elder mistreatment were recorded. Medics within the study region reported more cases of elder mistreatment during the implementation of the screening tool (relative risk [RR], 4.14; 95% CI, 3.25-5.27). After adjusting for changes in the number of elder mistreatment reports in the comparison groups (ie, underlying changes in reporting trends), the number of reports to APS increased (RR, 3.03; 95% CI, 2.06-4.46). The occurrence of elder mistreatment was validated in 83% (95% CI, 75%-91%) of the reports investigated by APS during the periods when medics did not have access to the screening tool compared with 82% (95% CI, 77%-87%) during the periods when medics had access to the screening tool, indicating that there were no differences in the proportion of reports that resulted in a validated APS investigation. CONCLUSIONS AND RELEVANCE: The findings suggest that incorporating the DETECT screening tool into the routine practices of medics is associated with substantial increases in the frequency with which clinicians report potential cases of elder mistreatment to APS. |
format | Online Article Text |
id | pubmed-7206507 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | American Medical Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-72065072020-05-13 Evaluation of the Detection of Elder Mistreatment Through Emergency Care Technicians Project Screening Tool Cannell, Brad Livingston, Melvin Burnett, Jason Parayil, Megin Reingle Gonzalez, Jennifer M. JAMA Netw Open Original Investigation IMPORTANCE: Elder mistreatment is underdetected and underreported. The more than 800 000 medics providing services in every county in the United States represent an important and underused surveillance system. OBJECTIVE: To investigate the association between the Detection of Elder Mistreatment Through Emergency Care Technician (DETECT) screening tool use and the number of medic reports made to Adult Protective Services (APS) over a period of approximately 3 years. DESIGN, SETTING, AND PARTICIPANTS: This quality improvement study used a difference in difference in differences design and included adults aged 65 years and older who were reported to Texas APS in the study region (246 cities in Denton, Johnson, and Tarrant Counties) between December 31, 2014, and February 28, 2018. EXPOSURES: The DETECT screening tool. MAIN OUTCOMES AND MEASURES: Reports to APS. RESULTS: The mean (SD) age of the 11 178 older adults included in this study was 76 (8) years (range, 65-105 years); there was no reported data on patient sex. A total of 18 080 reports of elder mistreatment were recorded. Medics within the study region reported more cases of elder mistreatment during the implementation of the screening tool (relative risk [RR], 4.14; 95% CI, 3.25-5.27). After adjusting for changes in the number of elder mistreatment reports in the comparison groups (ie, underlying changes in reporting trends), the number of reports to APS increased (RR, 3.03; 95% CI, 2.06-4.46). The occurrence of elder mistreatment was validated in 83% (95% CI, 75%-91%) of the reports investigated by APS during the periods when medics did not have access to the screening tool compared with 82% (95% CI, 77%-87%) during the periods when medics had access to the screening tool, indicating that there were no differences in the proportion of reports that resulted in a validated APS investigation. CONCLUSIONS AND RELEVANCE: The findings suggest that incorporating the DETECT screening tool into the routine practices of medics is associated with substantial increases in the frequency with which clinicians report potential cases of elder mistreatment to APS. American Medical Association 2020-05-07 /pmc/articles/PMC7206507/ /pubmed/32379330 http://dx.doi.org/10.1001/jamanetworkopen.2020.4099 Text en Copyright 2020 Cannell B et al. JAMA Network Open. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the CC-BY License. |
spellingShingle | Original Investigation Cannell, Brad Livingston, Melvin Burnett, Jason Parayil, Megin Reingle Gonzalez, Jennifer M. Evaluation of the Detection of Elder Mistreatment Through Emergency Care Technicians Project Screening Tool |
title | Evaluation of the Detection of Elder Mistreatment Through Emergency Care Technicians Project Screening Tool |
title_full | Evaluation of the Detection of Elder Mistreatment Through Emergency Care Technicians Project Screening Tool |
title_fullStr | Evaluation of the Detection of Elder Mistreatment Through Emergency Care Technicians Project Screening Tool |
title_full_unstemmed | Evaluation of the Detection of Elder Mistreatment Through Emergency Care Technicians Project Screening Tool |
title_short | Evaluation of the Detection of Elder Mistreatment Through Emergency Care Technicians Project Screening Tool |
title_sort | evaluation of the detection of elder mistreatment through emergency care technicians project screening tool |
topic | Original Investigation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7206507/ https://www.ncbi.nlm.nih.gov/pubmed/32379330 http://dx.doi.org/10.1001/jamanetworkopen.2020.4099 |
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