当前位置： SCI文献检索 > AGE AND AGEING期刊下所有文献 > A systematic review of outcomes following emergency transfer to hospital for residents of aged care facilities.

A systematic review of outcomes following emergency transfer to hospital for residents of aged care facilities.

Abstract：

BACKGROUND:residential aged care facility (RACF) resident numbers are increasing. Residents are frequently frail with substantial co-morbidity, functional and cognitive impairment with high susceptibility to acute illness. Despite living in facilities staffed by health professionals, a considerable proportion of residents are transferred to hospital for management of acute deteriorations in health. This model of emergency care may have unintended consequences for patients and the healthcare system. This review describes available evidence about the consequences of transfers from RACF to hospital. METHODS:a comprehensive search of the peer-reviewed literature using four electronic databases. Inclusion criteria were participants lived in nursing homes, care homes or long-term care, aged at least 65 years, and studies reported outcomes of acute ED transfer or hospital admission. Findings were synthesized and key factors identified. RESULTS:residents of RACF frequently presented severely unwell with multi-system disease. In-hospital complications included pressure ulcers and delirium, in 19 and 38% of residents, respectively; and up to 80% experienced potentially invasive interventions. Despite specialist emergency care, mortality was high with up to 34% dying in hospital. Furthermore, there was extensive use of healthcare resources with large proportions of residents undergoing emergency ambulance transport (up to 95%), and inpatient admission (up to 81%). CONCLUSIONS:acute emergency department (ED) transfer is a considerable burden for residents of RACF. From available evidence, it is not clear if benefits of in-hospital emergency care outweigh potential adverse complications of transfer. Future research is needed to better understand patient-centred outcomes of transfer and to explore alternative models of emergency healthcare.

journal_name

Age Ageing

journal_title

Age and ageing

authors

Dwyer R,Gabbe B,Stoelwinder JU,Lowthian J

doi

10.1093/ageing/afu117

subject

Has Abstract

pub_date

2014-11-01 00:00:00

pages

759-66

issue

eissn

0002-0729

issn

1468-2834

pii

afu117

journal_volume

pub_type

杂志文章,评审

在线工具

A systematic review of outcomes following emergency transfer to hospital for residents of aged care facilities.