Document Type

Journal Article

Publisher

Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine

Faculty

Faculty of Health, Engineering and Science

School

School of Nursing and Midwifery

RAS ID

16731

Comments

This is the accepted version of the following article: Harper, K., Gibson, N. P., Barton, A., Petta , A., Pearson, S., & Celenza, A. (2013). Effects of emergency department Care Coordination Team referrals in older people presenting with a fall. Emergency Medicine Australasia, 25(4), 324-333. Published in final form at here

Abstract

Objectives: The study aims to describe the characteristics of patients presenting to an ED with a fall and evaluate multidisciplinary Care Coordination Team (CCT) referrals on patient outcomes. Methods: A single-centred retrospective analysis of electronic data at an adult tertiary hospital was performed using data from 2004 to 2009 of presentations for patients aged 65 years or over with a fall. The primary outcome measure was representation to hospital within 30 days, comparing patients referred to CCT and those not referred. Secondary outcomes were differences in demographic characteristics, mode of arrival, triage score and readmission. Results: The proportion of ED patients presenting with a fall and their mean age is stable over time. From 2006 to 2009, 5162 fallers were referred to CCT in a decreasing trend, but with increased urgency. Statistically significant predictors for being referred to CCT were increasing age, being female, arriving by ambulance, being transferred from a nursing home and higher socioeconomic category. Arrival by ambulance and a history of previous falls were associated with representation and readmission. A decreasing trend from 2006 to 2009 was seen in rate ratios and odds ratios via regression modelling for both representation and readmission in patients referred to CCT. Conclusion: Maturing of the CCT is associated with a decrease in representation and readmission rate. Over time, the CCT attended higher urgency patients associated with stable admission rates. These associations were not significant and the clinical effectiveness of ED CCTs requires further examination.

DOI

10.1111/1742-6723.12098

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