Validating the DIVERT scales, CARS, and EARLI for predicting emergency department visits in home health care in Japan: A retrospective cohort study
Abstract Background The Detection of Indicators and Vulnerabilities for Emergency Room Trips (DIVERT) scale, the Community Assessment Risk Screen (CARS), and the Emergency Admission Risk Likelihood Index (EARLI) are scales that assess the risk of emergency department (ED) visits among home health ca...
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| Format: | Article |
| Language: | English |
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Wiley
2025-01-01
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| Series: | Journal of General and Family Medicine |
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| Online Access: | https://doi.org/10.1002/jgf2.738 |
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| author | Takao Ono Hiroko Watase Takuma Ishihara Taketo Watase Kiho Kang Mitsunaga Iwata |
| author_facet | Takao Ono Hiroko Watase Takuma Ishihara Taketo Watase Kiho Kang Mitsunaga Iwata |
| author_sort | Takao Ono |
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| description | Abstract Background The Detection of Indicators and Vulnerabilities for Emergency Room Trips (DIVERT) scale, the Community Assessment Risk Screen (CARS), and the Emergency Admission Risk Likelihood Index (EARLI) are scales that assess the risk of emergency department (ED) visits among home health care patients. This study validated these scales and explored factors that could improve their predictive accuracy among Japanese home health care patients. Methods This was a single‐center retrospective cohort study. The primary outcome of unplanned ED visits was used to assess the validity of the DIVERT scale, CARS, and EARLI. Additionally, we examined whether the addition of patient age and receipt of advance care planning as variables on these assessments could enhance their precision. Results Altogether, 40 (17.8%) had at least one ED visit during the 6 months study period. In these patients, the DIVERT scale, CARS, and EARLI of the patients with ≥1 ED visit was superior compared with no ED visit (both p < 0.05). The area under the curve (AUC) of the DIVERT scale, CARS, and EARLI were 0.62, 0.59, and 0.60, respectively. Adding patient age and receipt of advance care planning improved the AUC in all three scales. Conclusions Our findings suggest that these assessment scales could be applicable to home health care patients in Japan. Furthermore, adding age and receipt of advance care planning as variables was found to enhance the predictive accuracy of the scales. |
| format | Article |
| id | doaj-art-552fb70be3d14079a77bfc9504f124c5 |
| institution | Kabale University |
| issn | 2189-7948 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of General and Family Medicine |
| spelling | doaj-art-552fb70be3d14079a77bfc9504f124c52025-01-06T16:06:17ZengWileyJournal of General and Family Medicine2189-79482025-01-01261859110.1002/jgf2.738Validating the DIVERT scales, CARS, and EARLI for predicting emergency department visits in home health care in Japan: A retrospective cohort studyTakao Ono0Hiroko Watase1Takuma Ishihara2Taketo Watase3Kiho Kang4Mitsunaga Iwata5Department of Emergency Medicine and General Internal Medicine Fujita Health University School of Medicine Toyoake Aichi JapanDepartment of Emergency Medicine and General Internal Medicine Fujita Health University School of Medicine Toyoake Aichi JapanInnovative and Clinical Research Promotion Center Gifu University Hospital Gifu JapanDepartment of Emergency Medicine and General Internal Medicine Fujita Health University School of Medicine Toyoake Aichi JapanMidori Homon Clinic Nagoya Aichi JapanDepartment of Emergency Medicine and General Internal Medicine Fujita Health University School of Medicine Toyoake Aichi JapanAbstract Background The Detection of Indicators and Vulnerabilities for Emergency Room Trips (DIVERT) scale, the Community Assessment Risk Screen (CARS), and the Emergency Admission Risk Likelihood Index (EARLI) are scales that assess the risk of emergency department (ED) visits among home health care patients. This study validated these scales and explored factors that could improve their predictive accuracy among Japanese home health care patients. Methods This was a single‐center retrospective cohort study. The primary outcome of unplanned ED visits was used to assess the validity of the DIVERT scale, CARS, and EARLI. Additionally, we examined whether the addition of patient age and receipt of advance care planning as variables on these assessments could enhance their precision. Results Altogether, 40 (17.8%) had at least one ED visit during the 6 months study period. In these patients, the DIVERT scale, CARS, and EARLI of the patients with ≥1 ED visit was superior compared with no ED visit (both p < 0.05). The area under the curve (AUC) of the DIVERT scale, CARS, and EARLI were 0.62, 0.59, and 0.60, respectively. Adding patient age and receipt of advance care planning improved the AUC in all three scales. Conclusions Our findings suggest that these assessment scales could be applicable to home health care patients in Japan. Furthermore, adding age and receipt of advance care planning as variables was found to enhance the predictive accuracy of the scales.https://doi.org/10.1002/jgf2.738CARSDIVERT scaleEARLIemergency department visitshome health care |
| spellingShingle | Takao Ono Hiroko Watase Takuma Ishihara Taketo Watase Kiho Kang Mitsunaga Iwata Validating the DIVERT scales, CARS, and EARLI for predicting emergency department visits in home health care in Japan: A retrospective cohort study Journal of General and Family Medicine CARS DIVERT scale EARLI emergency department visits home health care |
| title | Validating the DIVERT scales, CARS, and EARLI for predicting emergency department visits in home health care in Japan: A retrospective cohort study |
| title_full | Validating the DIVERT scales, CARS, and EARLI for predicting emergency department visits in home health care in Japan: A retrospective cohort study |
| title_fullStr | Validating the DIVERT scales, CARS, and EARLI for predicting emergency department visits in home health care in Japan: A retrospective cohort study |
| title_full_unstemmed | Validating the DIVERT scales, CARS, and EARLI for predicting emergency department visits in home health care in Japan: A retrospective cohort study |
| title_short | Validating the DIVERT scales, CARS, and EARLI for predicting emergency department visits in home health care in Japan: A retrospective cohort study |
| title_sort | validating the divert scales cars and earli for predicting emergency department visits in home health care in japan a retrospective cohort study |
| topic | CARS DIVERT scale EARLI emergency department visits home health care |
| url | https://doi.org/10.1002/jgf2.738 |
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