The emergency to home project: impact of an emergency department care coordinator on hospital admission and emergency department utilization among seniors

AB-CB-ED Care Coordinator Impcat

Alberta (ED)

Background: Seniors comprise   14% to 21% of all emergency department (ED) visits, yet are   disproportionately larger users of ED and inpatient resources. ED care   coordinators (EDCCs) target seniors at risk for functional decline and   connect them to home care and other community services in hopes of avoiding   hospitalization. The goal of this study was to measure the association   between the presence of EDCCs and admission rates for seniors aged ≥ 65.   Secondary outcomes included length of stay, recidivism at 30 days, and   revisit resulting in admission at 30 days. 


Methods: This was a matched pairs study using administrative data from   eight EDs in six Alberta cities. Four of these hospitals were intervention   sites, in which patients were seen by an EDCC, while the other four sites had   no EDCC presence. All seniors aged ≥ 65 with a discharge diagnosis of fall or   musculoskeletal pathology were included. Cases were matched by CTAS category,   age, gender, mode of arrival, and home living environment. McNemar's test for   matched pairs was used to compare admission and recidivism rates at EDCC and   non-EDCC hospitals. A paired t-test was used to compare length of stay   between groups. 


Results:   There were no statistically significant differences for baseline admission   rate, revisit rate at 30 days, and readmission rate at 30 days between EDCC   and non-EDCC patients. 


Conclusions: This study showed no reduction in senior patients' admission   rates, recidivism at 30 days, or hospital length of stay when comparing   seniors seen by an EDCC with those not seen by an EDCC.


Authors: Christopher Matthew Bond, Elizabeth A Freiheit, Lesley Podruzny, Alianu Akawakun Kingsly, Dongmei Wang, Jamie Davenport, Abram Gutscher, Cathy Askin, Allison Taylor, Vivian Lee, Queenie Choo, Eddy Samuel Lang

Christopher Matthew Bond - sperss97@gmail.com

Project complete