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Emergency department outcome of elderly patients assisted by professional home services, the EPIGER study
- Source :
- BMC Geriatrics, BMC Geriatrics, BioMed Central, 2020, 20 (1), ⟨10.1186/s12877-020-01742-1⟩, BMC Geriatrics, Vol 20, Iss 1, Pp 1-10 (2020)
- Publication Year :
- 2020
- Publisher :
- BioMed Central, 2020.
-
Abstract
- Background For the elderly population living at home, the implementation of professional services tends to mitigate the effect of loss of autonomy and increases their quality of life. While helping in avoiding social isolation, home services could also be associated to different healthcare pathways. For elderly patients, Emergency Departments (EDs) are the main entrance to hospital where previous loss of autonomy is associated to worst hospital outcomes. Part of elderly patients visiting EDs are still admitted to hospital for having difficulties coping at home without presenting any acute medical issue. There is a lack of data concerning elderly patients visiting EDs assisted by home services. Our aim was to compare among elderly patients visiting ED those assisted by professional home services to those who do not in terms of emergency resources’ use and patients’ outcome. Methods A multicenter, prospective cohort study was performed in 124 French EDs during a 24-h period on March 2016.Consecutive patients living at home aged ≥80 years were included. The primary objective was to assess the risk of mortality for patients assisted by professional home services vs. those who were not. Secondary objectives included admission rate and specific admission rate for “having difficulties coping at home”. The primary endpoint was in-hospital mortality. Cox proportional-hazards regression model was used to test the association between professional home services and the primary endpoint. Multi variables logistic regressions were performed to assess secondary endpoints. Results One thousand one hundred sixty-eight patients were included, median age 86(83–89) years old,32% were assisted by professional home services. The overall in-hospital mortality rate was 7%. Assisted patients had more investigations performed. Home services were not associated with increased in-hospital mortality (HR = 1.34;95%CI [0.68–2.67]), nor with the admission rate (OR = 0.92;95%CI [0.65–1.30]). Assisted patients had a lower risk of being admitted for “having difficulties coping at home” (OR = 0.59;95%CI [0.38–0.92]). Conclusion Professional home services which assist one-third of elderly patients visiting EDs, were not associated to lower in-hospital mortality or to an increased admission rate. Assisted patients were associated to a lower risk of being admitted for «having difficulties coping at home».Professional home services could result in avoiding some admissions and their corollary complications. Trial registration Clinicaltrial.gov - NCT02900391, 09/14/2016, retrospectively registered
- Subjects :
- medicine.medical_specialty
Coping (psychology)
[SDV]Life Sciences [q-bio]
lcsh:Geriatrics
Lower risk
Home services
03 medical and health sciences
0302 clinical medicine
Elderly
Quality of life
Health care
medicine
Risk of mortality
Humans
Hospital Mortality
Prospective Studies
030212 general & internal medicine
Prospective cohort study
Aged
Aged, 80 and over
business.industry
Mortality rate
030208 emergency & critical care medicine
Emergency department
Healthcare access
3. Good health
Hospitalization
lcsh:RC952-954.6
Loss of autonomy
Emergency medicine
Quality of Life
Emergency care
Geriatrics and Gerontology
Emergency Service, Hospital
business
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 14712318
- Volume :
- 20
- Database :
- OpenAIRE
- Journal :
- BMC Geriatrics
- Accession number :
- edsair.doi.dedup.....7d4e7f790a12b69771d2e84543b78dcb