REDIRECT: reducing older patients' avoidable presentations for emergency care treatment

Mazza, Danielle; Pearce, Christopher; Lowthian, Judy; Browning, Colette J.; Shearer, Marianne; Joe, Angela; Turner, Lyle; Biezen, Ruby; Brijnath, Bianca

REDIRECT: reducing older patients' avoidable presentations for emergency care treatment

Date

2015

Authors

Mazza, Danielle

Pearce, Christopher

Lowthian, Judy

Browning, Colette J.

Shearer, Marianne

Joe, Angela

Turner, Lyle

Biezen, Ruby

Brijnath, Bianca

Publisher

Australian Primary Health Care Research Institute (APHCRI), The Australian National University.

Abstract

The project brings together researchers, primary and acute care service providers, and consumers with the primary aim of identifying strategies to reduce avoidable presentations of older patients to Emergency Departments (ED) by redirecting them to primary and community health services. The objectives are to: 1. Understand the journey of older patients who present to ED unnecessarily by analysing four datasets, which include data from regional and national levels, to identify the clinical, social, and health system-related risk factors for ED attendance and re-attendance 2. Identify the appropriate strategies for preventing older patient re-entry from primary health care to sub-acute or acute care 3. Establish the applicability of the proposed interventions at a regional level and the generalisability and feasibility of their implementation in other settings Synopsis Caring for an ageing population raises significant challenges to the health care system, including emergency care. Medicare Locals are charged with the task of reducing avoidable emergency department (ED) attendance partly by improving access to after-hours care. Research shows that increasing numbers of older patients (over 70 years) are attending ED, many over four times per year. To reduce avoidable presentations, we need to improve the options for managing the health care demand of this older age group in primary care and community settings. Accordingly, the project aims to: 1. Better understand the journey of older patients who present to ED unnecessarily and re-enter from primary health care to sub-acute or acute care by analysing four highly relevant datasets: MAGNET (Melbourne East Monash General Practice Database) MMDS (Melbourne Medical Deputising Services) dataset VEMD (Victorian Emergency Minimum Dataset) DYNOPTA (Dynamic Analyses to Optimise Ageing) dataset 2. Determine the appropriate strategies for preventing patient re-entry from primary health care to sub-acute or acute care by conducting a rapid review methodology. 3. Synthesise the above findings and propose alternative care models. Interviews and focus groups will be conducted with key stakeholders and older consumers and their carers to determine the applicability of these models at a local level and the generalisability of our findings to other settings.

Citation

Mazza D, Pearce C, Lowthian J, Browning C, Shearer M, Joe A, Turner LR, Biezen R, Brijnath B. REDIRECT: Reducing older patients’ avoidable presentations for emergency care treatment. Melbourne (AU): The Department of General Practice, Monash University; 2015.