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Related Experiment Videos

Emergency department usage by community step-down facilities--patterns and recommendations.

S W Lee1, C Goh, Y H Chan

  • 1Accident and Emergency Department, Changi General Hospital, 2 Simei Street 3, Singapore 529889.

Annals of the Academy of Medicine, Singapore
|November 25, 2003
PubMed
Summary

Community step-down facility (CSDF) residents frequently use emergency departments (EDs) for various medical needs. Streamlining ED processes is crucial for managing the growing elderly population and ensuring quality care for institutionalized patients.

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Area of Science:

  • Gerontology
  • Public Health
  • Emergency Medicine

Background:

  • Community step-down facilities (CSDFs) serve a growing elderly population requiring ongoing care.
  • The interface between CSDFs and acute hospital Emergency Departments (EDs) is complex and warrants examination.
  • Understanding ED utilization patterns by CSDF residents is essential for optimizing healthcare resource allocation.

Purpose of the Study:

  • To examine the interface between institutional community step-down facilities (CSDFs) and acute hospital Emergency Departments (EDs).
  • To provide a comprehensive description of ED service usage by nearby CSDFs.
  • To identify patterns and reasons for CSDF patient transfers to the ED.

Main Methods:

  • Prospective 12-week observational study conducted in an urban hospital's ED.

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  • Inclusion criteria: all patients transferred from CSDFs to the ED.
  • Data collection: extraction of clinical data, length of stay, and discharge diagnoses from hospital records.

    • Main Results:

    • 201 referrals from CSDFs to the ED over 3 months; median patient age 83 years.
    • 82% of transfers were admitted; common reasons included shortness of breath, cough, fever, and falls.
    • Average ED turnaround time was 97.94 minutes for admitted patients and 177 minutes for discharged patients.

    Conclusions:

    • CSDF residents utilize EDs for diverse medical conditions, highlighting a need for clearer ED roles in their care.
    • The study underscores the increasing demand on acute hospitals due to an aging population.
    • Streamlining ED processes is vital for delivering quality care to institutionalized elderly patients.