2019/06/13 by Jens Rauch, Rauch, Jens, Mathias Denter +3
Health Professions · Medicine · #Applications (stat.AP) #Chronic Disease Management Strategies #Emergency and Acute Care Studies #FOS: Computer and information sciences #Geriatric Care and Nursing Homes
paper · pdf · doi:10.48550/arxiv.1906.05641
openalex publication_date 2019/06/13 · openalex created_date 2022/07/28 · openalex updated_date 2026/07/28
Emergency department (ED) care for frail elderly patients is associated with\nan increased use of resources due to their complex medical needs and frequently\ndifficult psycho-social situation. To better target their needs with specially\ntrained staff, it is vital to determine the times during which these particular\npatients present to the ED. Recent research was inconclusive regarding this\nquestion and the applied methods were limited to coarse time windows. Moreover,\nthere is little research on time variation of frail ED patients' case\ncomplexity. This study examines differences in arrival rates for frail vs.\nnon-frail patients in detail and compares case complexity in frail patients\nwithin vs. outside of regular GP working hours. Arrival times and case\nvariables (admission rate, ED length of stay [LOS], triage level and\ncomorbidities) were extracted from the EHR of an ED in an urban German teaching\nhospital. We employed Poisson time series regression to determine patterns in\nhourly arrival rates over the week. Frail elderly patients presented more\nlikely to the ED during already high frequented hours, especially at midday and\nin the afternoon. Case complexity for frail patients was significantly higher\ncompared to non-frail patients, but varied marginally in time only with respect\nto triage level and ED LOS. The results suggest that frailty-attuned emergency\ncare should be available in EDs during the busiest hours. Based on EHR data,\nhospitals thus can tailor their staff needs.\n