Centre for Urgent and Emergency Care Research (CURE), Health Services Research, School of Health and Related Research, University of Sheffield, Sheffield, UK.
Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, UK.
Lancet Healthy Longev. 2022 Jun;3(6):e437-e447. doi: 10.1016/S2666-7568(22)00113-1. Epub 2022 Jun 9.
The proportion of adults older than 65 years is rapidly increasing. Care home residents in this age group have disproportionate rates of transfer to the Emergency Department (ED) and around 40% of attendances might be avoidable. We did a systematic review to identify factors that predict ED transfer from care homes. Six electronic databases were searched. Observational studies that provided estimates of association between ED attendance and variables at a resident or care home level were included. 26 primary studies met the inclusion criteria. Seven common domains of factors assessed for association with ED transfer were identified and within these domains, male sex, age, presence of specific comorbidities, polypharmacy, rural location, and care home quality rating were associated with likelihood of ED transfer. The identification of these factors provides useful information for policy makers and researchers intending to either develop interventions to reduce hospitalisations or use adjusted rates of hospitalisation as a care home quality indicator.
65 岁以上的成年人比例正在迅速增加。这一年龄组的养老院居民向急诊科（ED）转移的比例不成比例，大约 40%的就诊可能是可以避免的。我们进行了系统评价，以确定预测从养老院转移到急诊科的因素。检索了六个电子数据库。纳入了提供急诊科就诊与居民或养老院水平变量之间关联估计的观察性研究。26 项初级研究符合纳入标准。确定了与 ED 转移相关的七个常见因素领域，在这些领域中，男性、年龄、特定合并症、多种药物治疗、农村地区和养老院质量评级与 ED 转移的可能性相关。这些因素的确定为政策制定者和研究人员提供了有用的信息，他们希望开发干预措施以减少住院治疗，或使用调整后的住院率作为养老院质量指标。
