Identifying Potentially Avoidable Emergency Department Visits of Long-Term Care Hospital Residents in Korea: A Multicenter Retrospective Cohort Study

• Published in: BioMed research international Vol. 2019; no. 2019; pp. 1 - 7
• Main Authors: Choi, Seung Pil, Kim, Eui Chung, Kim, Duk Ho, Wee, Jung Hee, Yune, Ho Young, Lee, Dong Hoon, Kim, Keon, Lim, Jee Yong
• Format: Journal Article
• Language: English
• Published: Cairo, Egypt Hindawi Publishing Corporation 2019; Hindawi; Hindawi Limited
• Subjects: Aged; Aged, 80 and over; Cerebrovascular Disorders - epidemiology; Cerebrovascular Disorders - pathology; Cerebrovascular Disorders - therapy; Cohort analysis; Decision Making; Emergency medical care; Emergency medical services; Emergency Medical Services - standards; Emergency Service, Hospital; Female; Geriatrics; Health Facilities; Health insurance; Hospitals; Humans; Information systems; Long term health care; Long-term care; Long-Term Care - standards; Male; Medicine; Metropolitan areas; Nursing homes; Older people; Patient Transfer - standards; Patients; Republic of Korea - epidemiology; Republic of Korea; South Korea
• ISSN: 2314-6133; 2314-6141
• DOI: 10.1155/2019/7041607

The aims of this study were to investigate the reasons of transfers from long-term care hospitals (LTCHs) to emergency departments (EDs) of university hospitals in geriatric patients and to categorize the avoidable causes of these transfers. This retrospective multicenter study involved patients aged 65 years and older who were transferred from LTCHs to 5 EDs of university hospitals located in the metropolitan area of South Korea between January 2017 and December 2017. The expert panel reviewed and categorized the reason of transfers as avoidable or not. Moreover, we also investigated the number of patients with do-not-resuscitate (DNR) documents and the date these DNR documents were written. A total of 255,543 patients visited 5 EDs during the study period. Of these, 1,131 patients were from LTCHs. The number of potentially avoidable transfers was 168/1,131 (14.9%). The most common reason of avoidable transfers was noncritical diagnoses that could be assessed and managed in LTCHs (57.1%). There were 162 patients with DNR orders; of these, 12 had approved the DNR order before transfer. In conclusion, in Korea, potentially avoidable transfers could be reduced by managing noncritical diseases in LTCH and preparing advance care directives, including DNR orders, during admission to LTCH.