Emergency medicine Australasia : EMA · 2025
Enhancing Person-Centred Care in the Final Years of Life: Insights From Emergency Department Visits and Hospitalisations in Victorian Residential Aged Care (2015/16 to 2022/23).
СтатьяНазвание и аннотация: Перевод в очереди
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Alan Janine J, Laging Bridget, Cameron Peter, Laging Rohan, Boyd James, Porock Davina, Randall Sean
Аннотация
OBJECTIVE: To explore emergency hospitalisations from Victorian residential aged care facilities (RACFs).
METHODS: Retrospective descriptive study of Victorian RACFs transfers to ED from 2015/16 to 2022/23.
MAIN OUTCOME MEASURES: (1) ED event rate per 100 RACF beds; (2) Number of ED events, day/time, triage category, reason, comorbidity profile, length of stay, death within 12 months of ED presentation and costs; (3) Relationship between resident characteristics and total ED events; (4) Number of inpatient events, comorbidity profile, length of stay, intensive care use, preventable hospitalisations, diagnosis-related group, deaths and costs.
RESULTS: The rate of ED presentations from Victorian RACFs from 2015/16 to 2022/23 ranged from 77 to 91 ED events per 100 RACF beds. Associated costs for ED and inpatient stay were over $2.8B. An advance care directive or substitute decision maker was unavailable for 84% of ED events. Eighty-seven per cent of residents presenting to ED were admitted; 90% for medical DRGs. Sixteen per cent of inpatient stays were potentially preventable under the national definition.
CONCLUSION: Victorian RACF residents make substantial use of hospitals. This study highlights a significant gap in advance care planning (ACP), with causes potentially linked to inadequate planning, poor document quality or lack of accessibility. To enhance hospital-RACF interactions, it is essential to identify and address unmet palliative care needs at policy, planning, and practice levels, ensuring person-centred care for residents in their final years.
METHODS: Retrospective descriptive study of Victorian RACFs transfers to ED from 2015/16 to 2022/23.
MAIN OUTCOME MEASURES: (1) ED event rate per 100 RACF beds; (2) Number of ED events, day/time, triage category, reason, comorbidity profile, length of stay, death within 12 months of ED presentation and costs; (3) Relationship between resident characteristics and total ED events; (4) Number of inpatient events, comorbidity profile, length of stay, intensive care use, preventable hospitalisations, diagnosis-related group, deaths and costs.
RESULTS: The rate of ED presentations from Victorian RACFs from 2015/16 to 2022/23 ranged from 77 to 91 ED events per 100 RACF beds. Associated costs for ED and inpatient stay were over $2.8B. An advance care directive or substitute decision maker was unavailable for 84% of ED events. Eighty-seven per cent of residents presenting to ED were admitted; 90% for medical DRGs. Sixteen per cent of inpatient stays were potentially preventable under the national definition.
CONCLUSION: Victorian RACF residents make substantial use of hospitals. This study highlights a significant gap in advance care planning (ACP), with causes potentially linked to inadequate planning, poor document quality or lack of accessibility. To enhance hospital-RACF interactions, it is essential to identify and address unmet palliative care needs at policy, planning, and practice levels, ensuring person-centred care for residents in their final years.