![]() ![]() Results: Overall, 8.4% of ED visits were for ACSC, representing over 8 million potentially avoidable ED visits annually. We used Stata SE survey techniques to account for the complex survey design. Multivariate logistic regression was used to estimate the odds of all-cause, acute, and chronic ACSC visits. We constructed analytic groups aligned with Agency for Healthcare Research and Quality's priority populations. ![]() Outcomes were ACSC visits determined from the primary ED diagnosis. Methods: We analyzed data from the 2007-2009 National Hospital Ambulatory Medical Care Survey for 78,114 ED visits by adults aged 18 and older. We examined ED visits to identify subpopulations with disproportionate use of EDs for ACSC care. However, potentially preventable encounters with the health care system also occur in emergency department (ED) settings. Preventable emergency visit emergency department utilization nursing home resident.Introduction: Hospital care for ambulatory care sensitive conditions (ACSC) is potentially avoidable and often viewed as an indicator of suboptimal primary care. Those discharged from the ED often undergo important testing and receive medications that may alter their physical examination on return to the nursing facility, highlighting the need for seamless communication of the ED course to NHs. This nationally representative sample of older NH residents suggests ED visits for injury, those that are associated with normal triage vital signs, and those that are not associated with any diagnostic testing are potentially preventable. NH residents received centrally acting, sedating medications before ED discharge in 9.4% of visits. Computed tomography (CT) scans were performed in 25.4% and 30.1% of older NH residents who were discharged from the ED and admitted to the hospital, respectively, and more than 70% of these were CTs of the head. 001), whereas infections were 2.06 times as likely to be admitted as discharged (22.9% versus 11.1%, respectively). Injuries were 1.78 times more likely to be discharged than admitted (44.8% versus 25.3%, respectively, P <. More than half of visits (53.5%) did not lead to hospital admission of those discharged from the ED, 62.8% had normal vital signs on presentation and 18.9% did not have any diagnostic testing before ED discharge. When weighted to be nationally representative, these represent 13.97 million ED visits, equivalent to 1.8 ED visits annually per NH resident in the United States. ![]() Older NH residents accounted for 3857 of 208,956 ED visits during the time period of interest (1.8%). Patient demographics, ED visit information including testing performed, interventions (both procedures and medications) provided, and diagnoses treated. Older (age ≥65 years) NH residents with an ED visit during this time period. Nationally representative sample of US EDs federal hospitals and hospitals with fewer than 6 beds were excluded. Retrospective analysis of the 2005-2010 National Hospital Ambulatory Care Survey (NHAMCS), comparing ED visits by nursing home residents that did not lead to hospital admission (potentially preventable) with those that led to admission (less likely preventable). These visits are important because they are common, frequently lead to hospitalization, and can be associated with significant cost to the patient and the health care system. To identify and describe potentially preventable emergency department (ED) visits by nursing home (NH) residents in the United States. ![]()
0 Comments
Leave a Reply. |