Ambulatory Care Follow-Up and Fragmentation After Emergency Department Visits Among Older Adults.

IF 2 3区医学 Q2 GERONTOLOGY

Journal of Applied Gerontology Pub Date : 2025-09-25 DOI:10.1177/07334648251383345

Cameron J Gettel, Yuxiao Song, Theodore A Lee, Craig Rothenberg, Courtney Kitchen, Yixuan Liang, Julie P W Bynum, Susan N Hastings, Arjun K Venkatesh

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引用次数: 0

Abstract

ObjectivesThis study aimed to characterize ambulatory care patterns among older adults discharged from the emergency department (ED).MethodsThis retrospective cohort study of 55,391 ED visits from the 2015-2021 Medicare Current Beneficiary Survey examined ambulatory follow-up within 7 and 30 days. Care fragmentation was assessed by identifying visits where patients saw 2+ different providers. Zero-inflated negative binomial models analyzed associations between patient characteristics (e.g., dementia, multiple chronic conditions) and follow-up.ResultsFollow-up occurred in 22.9% and 44.2% of cases within 7 and 30 days, respectively. Care fragmentation occurred in 4.6% and 25.3% of cases. Dementia reduced follow-up odds (OR 0.74; 95% CI 0.66-0.84; p < 0.001), while multiple chronic conditions increased them (OR 1.27; 95% CI 1.19-1.36; p < 0.001).DiscussionMost older adults lack timely ED follow-up, and care can be fragmented. These patterns highlight the need for interventions to balance access and fragmentation while improving outcomes.

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老年人急诊科就诊后的门诊护理随访和碎片化。

目的：本研究旨在探讨从急诊科（ED）出院的老年人的门诊护理模式。方法：本回顾性队列研究对2015-2021年医疗保险现行受益人调查中55,391例急诊科就诊进行了7天和30天的门诊随访。通过确定患者看到2个以上不同提供者的访问来评估护理碎片化。零膨胀负二项模型分析了患者特征（如痴呆、多种慢性疾病）与随访之间的关系。结果随访时间分别为7天和30天，分别为22.9%和44.2%。护理碎片化发生率分别为4.6%和25.3%。痴呆降低了随访的几率（OR 0.74; 95% CI 0.66-0.84; p < 0.001），而多种慢性疾病增加了随访的几率（OR 1.27; 95% CI 1.19-1.36; p < 0.001）。大多数老年人缺乏及时的ED随访，护理可能是碎片化的。这些模式突出表明，需要采取干预措施，在改善结果的同时平衡可及性和分散性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Applied Gerontology GERONTOLOGY-

CiteScore

5.10

自引率

13.30%

发文量

202

期刊介绍： The Journal of Applied Gerontology (JAG) is the official journal of the Southern Gerontological Society. It features articles that focus on research applications intended to improve the quality of life of older persons or to enhance our understanding of age-related issues that will eventually lead to such outcomes. We construe application broadly and encourage contributions across a range of applications toward those foci, including interventions, methodology, policy, and theory. Manuscripts from all disciplines represented in gerontology are welcome. Because the circulation and intended audience of JAG is global, contributions from international authors are encouraged.