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Use of Emergency Departments by Frail Elderly Patients : Temporal Patterns and Case Complexity

  • Emergency department (ED) care for frail elderly patients is associated with an increased use of resources due to their complex medical needs and frequently difficult psycho-social situation. To better target their needs with specially trained staff, it is vital to determine the times during which these particular patients present to the ED. Recent research was inconclusive regarding this question and the applied methods were limited to coarse time windows. Moreover, there is little research on time variation of frail ED patients’ case complexity. This study examines differences in arrival rates for frail vs. non-frail patients in detail and compares case complexity in frail patients within vs. outside of regular GP working hours. Arrival times and case variables (admission rate, ED length of stay [LOS], triage level and comorbidities) were extracted from the EHR of an ED in an urban German teaching hospital. We employed Poisson time series regression to determine patterns in hourly arrival rates over the week. Frail elderly patients presented more likely to the ED during already high frequented hours, especially at midday and in the afternoon. Case complexity for frail patients was significantly higher compared to non-frail patients, but varied marginally in time only with respect to triage level and ED LOS. The results suggest that frailty-attuned emergency care should be available in EDs during the busiest hours. Based on EHR data, hospitals thus can tailor their staff needs.

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Metadaten
Author:Jens Rauch, Ursula Hertha HübnerORCiD
Title (English):Use of Emergency Departments by Frail Elderly Patients : Temporal Patterns and Case Complexity
URN:urn:nbn:de:bsz:959-opus-20442
DOI:https://doi.org/10.3233/SHTI190830
ISBN:978-1-64368-016-3
ISBN:978-1-64368-017-0
Parent Title (English):German Medical Data Sciences : Shaping Change – Creative Solutions for Innovative Medicine
Publisher:IOS Press
Place of publication:Amsterdam
Document Type:Conference Proceeding
Language:English
Year of Completion:2019
Release Date:2021/05/20
First Page:215
Last Page:223
Note:
64th Annual Meeting of the German Association of Medical Informatics, Biometry and Epidemiology (GMDS e.V.), 08.11. - 11.09.2019, Dortmund
Faculties:Fakultät WiSo
DDC classes:600 Technik, Medizin, angewandte Wissenschaften / 610 Medizin, Gesundheit
Review Status:Veröffentlichte Fassung/Verlagsversion
Licence (German):License LogoCreative Commons - CC BY-NC - Namensnennung - Nicht kommerziell 4.0 International