Rapid two-stage emergency department intervention for seniors: impact on continuity of care.

摘要: Objectives: A two-stage intervention comprising screening and a brief standardized nursing assessment referral, for emergency department (ED) patients aged 65 years over, reduced the rate of functional decline four months after visit, without increasing societal costs. In this study, authors investigated effects on process care at, during month after, ED visit. Methods: Patients at Montreal hospital EDs were randomized by day visit to or usual care. admitted excluded. Measures included: referrals visits primary physician local community health center, home other services, return visits. Data sources included charts, patient questionnaires, provincial administrative databases. Results: The study sample 166 179 control group ready discharge from ED. Intervention more likely have chart-documented referral their center [adjusted odds ratio (OR) 4.0, 95% confidence interval (95% CI) = 1.7 9.5] OR 1.9, CI 1.0 3.4], received services one 2.3, 1.1 5.1]. Unexpectedly, they also make 1.6, 2.6]. Conclusions: beneficial outcomes appear result primarily early provision rather than contact with physician.