title: The emergency to home project: impact of an emergency department care coordinator on hospital admission and emergency department utilization among seniors.
abstract: BACKGROUND
  Seniors comprise 14% to 21% of all emergency department (ED) visits, yet are disproportionately larger users of ED and inpatient resources. ED care coordinators (EDCCs) target seniors at risk for functional decline and connect them to home care and other community services in hopes of avoiding hospitalization. The goal of this study was to measure the association between the presence of EDCCs and admission rates for seniors aged ≥ 65. Secondary outcomes included length of stay, recidivism at 30 days, and revisit resulting in admission at 30 days.
  
  
  METHODS
  This was a matched pairs study using administrative data from eight EDs in six Alberta cities. Four of these hospitals were intervention sites, in which patients were seen by an EDCC, while the other four sites had no EDCC presence. All seniors aged ≥ 65 with a discharge diagnosis of fall or musculoskeletal pathology were included. Cases were matched by CTAS category, age, gender, mode of arrival, and home living environment. McNemar's test for matched pairs was used to compare admission and recidivism rates at EDCC and non-EDCC hospitals. A paired t-test was used to compare length of stay between groups.
  
  
  RESULTS
  There were no statistically significant differences for baseline admission rate, revisit rate at 30 days, and readmission rate at 30 days between EDCC and non-EDCC patients.
  
  
  CONCLUSIONS
  This study showed no reduction in senior patients' admission rates, recidivism at 30 days, or hospital length of stay when comparing seniors seen by an EDCC with those not seen by an EDCC.
authors: Department of Emergency Medicine, Foothills Medical Centre, Room C231, 1403-29 St NW, Calgary, Alberta T2N 2 T9, Canada.
authors: Christopher Matthew
authors: CM
authors: Bond
authors: Department of Family Medicine, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 1 N4, Canada.
authors: Elizabeth A
authors: EA
authors: Freiheit
authors: Alberta Health Services, Seventh Street Plaza, 10030-107 St NW, Edmonton, Alberta T5J 3E4, Canada.
authors: Lesley
authors: L
authors: Podruzny
authors: Department of Family Medicine, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 1 N4, Canada.
authors: Alianu Akawakun
authors: AA
authors: Kingsly
authors: Department of Emergency Medicine, Foothills Medical Centre, Room C231, 1403-29 St NW, Calgary, Alberta T2N 2 T9, Canada.
authors: Dongmei
authors: D
authors: Wang
authors: Alberta Health Services, Seventh Street Plaza, 10030-107 St NW, Edmonton, Alberta T5J 3E4, Canada.
authors: Jamie
authors: J
authors: Davenport
authors: Alberta Health Services, Seventh Street Plaza, 10030-107 St NW, Edmonton, Alberta T5J 3E4, Canada.
authors: Abram
authors: A
authors: Gutscher
authors: Alberta Health Services, Reporting Services, Data Integration Measurement and Reporting, NWII, Suite 300, 4520-16 Ave NW, Calgary, Alberta T3B 0 M6, Canada.
authors: Cathy
authors: C
authors: Askin
authors: Alberta Health Services, Seventh Street Plaza, 10030-107 St NW, Edmonton, Alberta T5J 3E4, Canada.
authors: Allison
authors: A
authors: Taylor
authors: Alberta Health Services, Seventh Street Plaza, 10030-107 St NW, Edmonton, Alberta T5J 3E4, Canada.
authors: Vivian
authors: V
authors: Lee
authors: Alberta Health Services, Seventh Street Plaza, 10030-107 St NW, Edmonton, Alberta T5J 3E4, Canada.
authors: Queenie
authors: Q
authors: Choo
authors: Department of Emergency Medicine, Foothills Medical Centre, Room C231, 1403-29 St NW, Calgary, Alberta T2N 2 T9, Canada.
authors: Eddy Samuel
authors: ES
authors: Lang
keywords: Discharge planning; ED aftercare; Elderly; Falls; Geriatric EM care; Home care; Recidivism; Seniors