Older patients’ perspectives on factors contributing to frequent visits to the emergency department: a qualitative interview study

Older patients’ perspectives on factors contributing to frequent visits to the emergency department: a qualitative interview study

Background Older patients are at high risk of unplanned revisits to the emergency department (ED) because of their medical complexity. To reduce the number of ED visits, we need more knowledge about the patient-level, environmental, and healthcare factors involved. The aim of this study was to descr...

Full description

Saved in:
Bibliographic Details
Published in:BMC public health Vol. 21; no. 1; pp. 1 - 1709
Main Authors: Kolk, Daisy, Kruiswijk, Anton F, MacNeil-Vroomen, Janet L, Ridderikhof, Milan L, Buurman, Bianca M
Format: Journal Article
Language:English
Published: London BioMed Central Ltd 20-09-2021
BioMed Central
BMC
Subjects:
Acute care
Aged
Aged patients
Care and treatment
Chronic illnesses
Complex patients
Data analysis
Emergency medical care
Emergency medical services
Emergency service
Family physicians
Geriatrics
Health care
Health care facilities
Health problems
Hospitals
Informed consent
Interviews
Medical emergencies
Medical research
Older people
Patient experiences
Patients
Public health
Qualitative research
Recovery
Risk factors
Surveys
Theoretical analysis
Netherlands
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Older patients are at high risk of unplanned revisits to the emergency department (ED) because of their medical complexity. To reduce the number of ED visits, we need more knowledge about the patient-level, environmental, and healthcare factors involved. The aim of this study was to describe older patients' perspectives and experiences before and after an ED visit, and to identify factors that possibly contribute to frequent ED revisits. Methods This was a qualitative description study. We performed semi-structured individual interviews with older patients who frequently visited the ED and were discharged home after an acute visit. Patients were enrolled in the ED of a university medical centre using purposive sampling. Interviews were recorded, transcribed, and coded independently by two researchers. Theoretical analysis was used to identify recurring patterns and themes in the data. Interviews were conducted until thematic saturation was reached. Results In-depth interviews were completed with 13 older patients. Three main themes emerged: 1) medical events leading to feelings of crisis, 2) patients' untreated health problems, and 3) persistent problems in health and daily functioning post discharge. Participants identified problems before and after their ED visit that possibly contributed to further ED visits. These problems included increasing symptoms leading to feelings of crisis, the relationship with the general practitioner, incomplete discharge information at the ED, and inadequate follow-up and lack of recovery after an ED visit. Conclusions This qualitative study identified multiple factors that may contribute to frequent ED visits among older patients. Older patients in need of acute care might benefit from hospital-at-home interventions, or acute care provided by geriatric emergency teams in the primary care setting. Identifying frailty in the ED is needed to improve discharge communication and adequate follow-up is needed to improve recovery after an acute ED visit. Keywords: Patient experiences, Aged, Geriatrics, Qualitative research, Acute care
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1471-2458
1471-2458
DOI:10.1186/s12889-021-11755-z