Elderly patients re-transferred from long-term care hospitals to emergency departments within 48 h
Abstract Background & objectives The increasing proportion of elderly populations has led to a rise in chronic diseases and frequent transfers between long-term care hospitals (LTCHs) and emergency departments (EDs). This study investigates the patterns of risk factors of initial-transfers and s...
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| Language: | English |
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BMC
2024-11-01
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| Series: | BMC Emergency Medicine |
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| Online Access: | https://doi.org/10.1186/s12873-024-01140-5 |
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| author | Tae Young Lee Sung‑keun Ko Seong Jung Kim Jin‑Hee Lee |
| author_facet | Tae Young Lee Sung‑keun Ko Seong Jung Kim Jin‑Hee Lee |
| author_sort | Tae Young Lee |
| collection | DOAJ |
| description | Abstract Background & objectives The increasing proportion of elderly populations has led to a rise in chronic diseases and frequent transfers between long-term care hospitals (LTCHs) and emergency departments (EDs). This study investigates the patterns of risk factors of initial-transfers and subsequent re-transfers among patients aged 65 or older. Specifically, we focus on those re-transferred from LTCHs to EDs within 48 h of discharge, often without adequate treatment. Method This nationwide cross-sectional study used data from South Korea’s National Emergency Department Information System (NEDIS) from January 1, 2017, to December 31, 2019. Patients aged 65 or older who were initially transferred from LTCHs to EDs and re-transferred within 48 h, were identified. Logistic regression was employed to analyze risk factors associated with re-transfers. Results 140,282 elderly patients were identified as having been transferred from LTCHs to EDs. Of these, 38,180 patients received emergency care in the EDs and were discharged back to LTCHs. Among them, 679 patients were returned to LTCHs after receiving acute treatment but revisited the EDs within 48 h. Hospital ward admission rates were higher for re-transferred patients (71.3%) compared to initial transfers (42.1%, p < 0.0001). Risk factors for re-transfer included male, nighttime admissions, and longer ED stays (> 6 h). Tertiary hospitals showed higher re-transfer rates to other facilities (13.1%) than general hospitals (2.9%). Conclusion This study reveals that many health outcomes worsen upon re-transfer compared to the initial-transfer. These findings underscore the need for a coordinated healthcare system that ensures elderly patients from long-term care facilities are initially sent to appropriate hospitals during the initial transfer, which could mitigate repeated ED visits and ensure timely care. |
| format | Article |
| id | doaj-art-9beed1c4bcae4a979c2a8a5e94d9ab76 |
| institution | Kabale University |
| issn | 1471-227X |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Emergency Medicine |
| spelling | doaj-art-9beed1c4bcae4a979c2a8a5e94d9ab762024-12-01T12:12:58ZengBMCBMC Emergency Medicine1471-227X2024-11-012411810.1186/s12873-024-01140-5Elderly patients re-transferred from long-term care hospitals to emergency departments within 48 hTae Young Lee0Sung‑keun Ko1Seong Jung Kim2Jin‑Hee Lee3National Emergency Medical Center, National Medical CenterNational Emergency Medical Center, National Medical CenterNational Emergency Medical Center, National Medical CenterNational Emergency Medical Center, National Medical CenterAbstract Background & objectives The increasing proportion of elderly populations has led to a rise in chronic diseases and frequent transfers between long-term care hospitals (LTCHs) and emergency departments (EDs). This study investigates the patterns of risk factors of initial-transfers and subsequent re-transfers among patients aged 65 or older. Specifically, we focus on those re-transferred from LTCHs to EDs within 48 h of discharge, often without adequate treatment. Method This nationwide cross-sectional study used data from South Korea’s National Emergency Department Information System (NEDIS) from January 1, 2017, to December 31, 2019. Patients aged 65 or older who were initially transferred from LTCHs to EDs and re-transferred within 48 h, were identified. Logistic regression was employed to analyze risk factors associated with re-transfers. Results 140,282 elderly patients were identified as having been transferred from LTCHs to EDs. Of these, 38,180 patients received emergency care in the EDs and were discharged back to LTCHs. Among them, 679 patients were returned to LTCHs after receiving acute treatment but revisited the EDs within 48 h. Hospital ward admission rates were higher for re-transferred patients (71.3%) compared to initial transfers (42.1%, p < 0.0001). Risk factors for re-transfer included male, nighttime admissions, and longer ED stays (> 6 h). Tertiary hospitals showed higher re-transfer rates to other facilities (13.1%) than general hospitals (2.9%). Conclusion This study reveals that many health outcomes worsen upon re-transfer compared to the initial-transfer. These findings underscore the need for a coordinated healthcare system that ensures elderly patients from long-term care facilities are initially sent to appropriate hospitals during the initial transfer, which could mitigate repeated ED visits and ensure timely care.https://doi.org/10.1186/s12873-024-01140-5Elderly patientsEmergency departmentsLong-term care hospitalInitial transferRe-transferChronic disease management |
| spellingShingle | Tae Young Lee Sung‑keun Ko Seong Jung Kim Jin‑Hee Lee Elderly patients re-transferred from long-term care hospitals to emergency departments within 48 h BMC Emergency Medicine Elderly patients Emergency departments Long-term care hospital Initial transfer Re-transfer Chronic disease management |
| title | Elderly patients re-transferred from long-term care hospitals to emergency departments within 48 h |
| title_full | Elderly patients re-transferred from long-term care hospitals to emergency departments within 48 h |
| title_fullStr | Elderly patients re-transferred from long-term care hospitals to emergency departments within 48 h |
| title_full_unstemmed | Elderly patients re-transferred from long-term care hospitals to emergency departments within 48 h |
| title_short | Elderly patients re-transferred from long-term care hospitals to emergency departments within 48 h |
| title_sort | elderly patients re transferred from long term care hospitals to emergency departments within 48 h |
| topic | Elderly patients Emergency departments Long-term care hospital Initial transfer Re-transfer Chronic disease management |
| url | https://doi.org/10.1186/s12873-024-01140-5 |
| work_keys_str_mv | AT taeyounglee elderlypatientsretransferredfromlongtermcarehospitalstoemergencydepartmentswithin48h AT sungkeunko elderlypatientsretransferredfromlongtermcarehospitalstoemergencydepartmentswithin48h AT seongjungkim elderlypatientsretransferredfromlongtermcarehospitalstoemergencydepartmentswithin48h AT jinheelee elderlypatientsretransferredfromlongtermcarehospitalstoemergencydepartmentswithin48h |