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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Functional Decline Predicts Emergency Department Use in Veterans With Dementia
Stephanie Ng1, Robert O Morgan2, Annette Walder3
1Baylor College of Medicine, Houston, TX, USA Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Houston, TX, USA.
Background:
We examined emergency room (ER) utilization by persons with dementia (PWDs) using caregiver and patient characteristics as predictors.
Methods:
A secondary analysis of 296 veteran-caregiver dyads. Caregivers recorded PWD baseline characteristics and noted ER visits over the next year. Two sets of regression models analyzed categorical ER use and repeat ER use.
Results:
In the univariate analysis, categorical use of the ER was predicted by patients' functional status (P ≤ .008) and Veterans Affairs priority grouping (P ≤ .02). Repeat ER admissions were predicted by functional status (P ≤ .04), number of chronic conditions (P ≤ .01), and caregiver-reported relationship strain (P ≤ .04). In multivariate analysis, categorical ER use was predicted by functional status (P ≤ .02), priority grouping (P ≤ .03), and number of chronic conditions (P ≤ .06).
Conclusions:
Functional status most strongly predicted ER use, highlighting the promise of home-based interventions to improve activities of daily living. Number of chronic conditions and caregiver-reported relationship strain are potential targets of intervention during discharge process.
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