Toppling Oranges: Death, Disability, Decline, and Readmission of Community-Dwelling Elderly Patients After an Emergency Department Visit
| Autor: | Kenneth Frumkin |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Referral Patient Readmission Risk Assessment 03 medical and health sciences 0302 clinical medicine Financial incentives Risk Factors Activities of Daily Living Hospital discharge Medicine Humans 030212 general & internal medicine Functional decline Geriatric Assessment Aged Geriatrics Aged 80 and over Clinical Deterioration business.industry Emergency department Prognosis Patient Discharge Increased risk Emergency medicine Emergency Medicine Quality of Life Female Independent Living business Emergency Service Hospital Revolving door 030217 neurology & neurosurgery |
| Zdroj: | The Journal of emergency medicine. 58(2) |
| ISSN: | 0736-4679 |
| Popis: | Background Every emergency department (ED) faces both a rising tide and a revolving door of elderly patients. Unplanned short-term returns after a recent ED evaluation or hospital admission are sentinel events. Consequences include substantial functional decline, reduced health-related quality of life, and increased risk of dependency or death. Returning families, unaware of the significant likelihood of deterioration after an ED or hospital discharge, often harbor suspicions that something was missed. Literature describing the significant likelihood of functional decline in elderly patients after ED or hospital discharge is presented. Suggestions for incorporating the potential for subsequent deterioration into the evaluation of elderly ED patients and the discussions surrounding disposition decisions are included. Discussion In addition to impacting patients and families, posthospitalization decline and short-term readmissions create serious burdens for hospitals and their EDs. Education, vigilance, specialized geriatric EDs, dedicated inpatient units, and ED access to outpatient services for the elderly can aid in the recognition and mitigation of postvisit functional decline and associated returns. Financial incentives for reducing short-term readmissions can translate into novel approaches and referral arrangements. Conclusions Currently, and for the foreseeable future, EDs are integral to predicting, identifying, and preventing functional decline in the elderly. For now, we are all Geriatric EDs. |
| Databáze: | OpenAIRE |
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