Exploring Predictive Factors for Potentially Avoidable Emergency Department Transfers: Findings From the FINE Study

Area of Science:

• Gerontology
• Health Services Research
• Emergency Medicine

Background:

• Potentially avoidable transfers (PAT) from nursing homes (NHs) to emergency departments (EDs) represent a significant burden on healthcare systems.
• Identifying factors associated with PAT is crucial for developing targeted interventions to improve care quality and reduce unnecessary hospitalizations.

Purpose of the Study:

• To determine the prevalence of PAT among NH residents.
• To identify resident- and NH-level factors associated with PAT to EDs.

Main Methods:

• Secondary analysis of the multicenter observational FINE study.
• Included 1017 NH residents transferred to EDs between January and December 2016.
• Multivariable mixed logistic regression analysis was used to identify factors associated with PAT.

Main Results:

• A high prevalence of PAT was observed, with 87.02% of transfers categorized as potentially avoidable.
• Patient factors like behavioral disturbances and recent falls were associated with higher PAT rates.
• Factors such as shorter ED-NH distance, palliative care training, direct hospitalization availability, and lower comorbidity scores were associated with lower PAT rates.

Conclusions:

• Potentially avoidable transfers from NHs to EDs are common, indicating substantial room for improvement in care coordination and transfer protocols.
• Findings suggest targeted interventions at both the NH and resident levels are needed to reduce PAT.
• Future strategies should focus on addressing behavioral issues and enhancing palliative care within NHs.