Key result
Emergency telephone triage refers older adults to the ED where ~44% are discharged directly home.
Why the study?
To map the referral pathways of elderly people following telephone calls to Emergency Medical Communication Centers in France.
Observational (n=692)
Yes
Over half of elderly patients calling emergency medical communication centers are referred to the ED, but nearly half of those are discharged home, suggesting a need for better geriatric triage.
High rates of direct home discharge after ED referral in elderly patients; hypothesis-generating for refined geriatric telephone triage protocols.
OBJECTIVES: To map the referral pathways of elderly people after telephone calls to Emergency Medical Communication Centers (ECC) in France. DESIGN: Retrospective observational study. SETTING: ECC and Emergency Departments (ED) of the Rhone region in France in 2013. PARTICIPANTS: Patients aged 75 years and older who called or had calls made to the ECC on 7 non-consecutive days (n = 712). MEASUREMENTS: All calls made by/for patients aged 75 and over were analyzed. Data were collected regarding geriatric assessment and patient discharge destination after admission to an ED. RESULTS: All 4168 calls received over the 7 days were analyzed. Of these, 692 involved the care of elderly people and were included. The median call duration was 2min59 [1min57; 4min13]. Following the call, 35% of the patients remained at home, 62% were referred to ED and 3% were directly hospitalized in intensive care units. Of the patients admitted to ED, 73% had a stable clinical condition and the main reason for admission was a fall (28%). Following ED care, 56% of patients were hospitalized and 44% returned directly home. CONCLUSION: Over half the elderly patients included in this study were referred to an ED after a call to ECC. For half of them, their clinical condition was considered stable and they were discharged after the ED visit. A more appropriate assessment of clinical conditions among geriatric patients could help to improve patient triage during ECC calls, and therefore reduce ED referrals.
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Vincent et al. (2019) conducted an observational in Emergency medical calls (n=692). Telephone triage by Emergency Medical Communication Center was evaluated on Referral pathways and discharge destination. Following telephone triage by an Emergency Medical Communication Center, 62% of patients aged ≥75 years were referred to the emergency department, of whom 44% were discharged directly home.
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