| Autor: |
Kim K; Department of Emergency Medicine, Ewha Womans University Hospital, Seoul 07985, Republic of Korea., Lee DH; Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul 06973, Republic of Korea., Yune HY; Department of Emergency Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong-si, Gyeonggi-do 18450, Republic of Korea., Wee JH; Department of Emergency Medicine, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul 07345, Republic of Korea., Kim DH; Department of Emergency Medicine, Eulji University, Seoul 01830, Republic of Korea., Kim EC; Department of Emergency Medicine, CHA University School of Medicine, Seongnam-si 13496, Republic of Korea., Lim JY; Department of Emergency Medicine, Seoul St. Mary's Hospital, Seoul 065691, Republic of Korea., Choi SP; Department of Emergency Medicine, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul 07345, Republic of Korea. |
| Abstrakt: |
The aims of this study were to investigate the reasons of transfers from long-term care hospitals (LTCHs) to emergency departments (EDs) of university hospitals in geriatric patients and to categorize the avoidable causes of these transfers. This retrospective multicenter study involved patients aged 65 years and older who were transferred from LTCHs to 5 EDs of university hospitals located in the metropolitan area of South Korea between January 2017 and December 2017. The expert panel reviewed and categorized the reason of transfers as avoidable or not. Moreover, we also investigated the number of patients with do-not-resuscitate (DNR) documents and the date these DNR documents were written. A total of 255,543 patients visited 5 EDs during the study period. Of these, 1,131 patients were from LTCHs. The number of potentially avoidable transfers was 168/1,131 (14.9%). The most common reason of avoidable transfers was noncritical diagnoses that could be assessed and managed in LTCHs (57.1%). There were 162 patients with DNR orders; of these, 12 had approved the DNR order before transfer. In conclusion, in Korea, potentially avoidable transfers could be reduced by managing noncritical diseases in LTCH and preparing advance care directives, including DNR orders, during admission to LTCH. |
