Elderly patients, or older adults, who are aged 65 years and older, compose of up to 20% emergency department (ED) encounters, and they experience more patient safety incidents and negative outcomes, such as higher admission rate, increased mortality, longer hospital stay, and more ED revisits. Particularly, 18% of their ED visits are fall related, exhibiting a steady increase in death, admission, and readmission rates due to fall injuries. This paper from HIP Investigator Dr. Maureen Smith introduces a transition flow model to study fall-related emergency department (ED) revisits for elderly patients with diabetes.
Five diabetes classes are used to classify patients at discharge, within 7-day revisits, and between 8 and 30-day revisits. Analytical formulas to evaluate patient revisiting risks are derived. To reduce revisits, sensitivity analysis is introduced to identify the most critical, i.e., dominant, factors whose changes can lead to the largest reduction in revisits. In addition, a case study at University of Wisconsin (UW) Hospital ED is described to illustrate the applicability of the model.
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