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ID
Source
Brief title
Health condition
older adults, emergency department, adverse outcomes, aftercare, patient discharge, elderly
ouderen, spoedeisende hulp, nazorg, oudere patient
Sponsors and support
Intervention
Outcome measures
Primary outcome
The difference in hospital admissions within 30 days after ED discharge between the intervention and the control group.
Secondary outcome
The difference in unanticipated avoidable hospital admissions within 30 days after ED discharge, unanticipated, avoidable ED return visits within 30 days after ED discharge, difference in functional outcome 30 days after ED discharge and difference in patient satisfaction between the two groups and cost-effectiveness.
Background summary
Elderly patients, discharged to a home setting from the Emergency Department (ED) may be at high risk for adverse outcomes. To improve their outcome, telephone aftercare was started in our hospital. We would like to assess whether telephone aftercare for patients of ≥70 years after ED discharge to a home setting leads to reduction in hospital admissions and return ED visits within 30 days, better patient satisfaction and cost-effectiveness. We will conduct a comparative study with two groups: an intervention group, who will receive a telephone call from a specialized ED nurse during which discharge instructions are reviewed, follow-up appointments and care are facilitated and patient satisfaction will be scored, and a control group who will receive a patient satisfaction survey telephone call. After 30 days health service use of all patients will be evaluated.
Study objective
We hypothesize that telephone aftercare for patients of 70 years and older within 24 hours after discharge to a home setting from the ED will lead to a reduction in hospital admission, in avoidable, unanticipated hospital admissions and ED visits within 30 days after the ED visit; that it will improve patient satisfaction; and that it will be cost-effective. We hypothesize that for patients with cognitive impairment and hazardous alcohol use telephone aftercare will not be as effective, whereas decreased general daily functioning and crowding in the ED during discharge of the patient will predict a positive effect of telephone aftercare.
Study design
30 days after ED discharge
Intervention
Patients in the intervention group will receive a telephone call from a specialized ED nurse within 24 hours after ED discharge during which discharge instructions are reviewed and follow-up appointments and care are facilitated if needed. Patients will also be asked to give a satisfaction score for the treatment they received in the ED. Patients in the control group will receive a patient satisfaction survey telephone call within 24 hours after ED discharge.
Inclusion criteria
ED patients (1) age 70 years and older (2) returning to a home setting after ED discharge and (3) willing to participate.
Exclusion criteria
ED patients will be excluded if they are <70 years of age, admitted to the hospital, transferred to or from another hospital, discharged to a nursing home, or if they do not have a telephone.
Design
Recruitment
Followed up by the following (possibly more current) registration
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Other (possibly less up-to-date) registrations in this register
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In other registers
| Register | ID |
|---|---|
| NTR-new | NL6598 |
| NTR-old | NTR6815 |
| Other | METC Zuidwest Holland : 17-028 |