Can a Rapid 2 Day Followup After Discharge From the ED Reduce Readmissions and Death for Patients 75 Years and Older?
Our hypothesis is that a rapid follow up for elderly patients in a Geriatric Clinic discharged from the Emergency Department (ED) will have fewer unplanned return ED visits and fewer unplanned hospital admissions with no attendant increase in mortality.
Patients 75 years of age and older will be randomized following discharge from the ED into two groups. The first will receive standard post ED care. The second will receive an appointment to our Geriatric Clinic within 2-3 days for stabilization, further treatment and contact with the patient's primary physician to communicate the course of the patient's illness and to schedule subsequent follow-up with the patients regular medical provider.
There will be two primary outcomes: The first will be a composite of morality and/or return to the ED at 30 days, and the secondary primary outcome will be mortality. Economic data regarding resource utilization by patients will also be analyzed.
|Study Design:||Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Prevention
|Official Title:||A Randomized Trial of the Effect of a Geriatrics Appointment Within 2-3 Days of Discharge From the Emergency Department(ED) in Reducing ED and Hospital Readmissions for Patients 75 Years of Age and Older.|
- Mortality and readmissions to emergency department [ Time Frame: 30 and 180 days ] [ Designated as safety issue: No ]
- Mortality [ Time Frame: 30 and 180 days ] [ Designated as safety issue: No ]Secondary outcome to measure all cause mortality for patients admitted to the study.
- Medical Resource utilization [ Time Frame: 30 days and 180 days ] [ Designated as safety issue: No ]
|Study Start Date:||August 2013|
|Estimated Study Completion Date:||August 2014|
|Estimated Primary Completion Date:||August 2014 (Final data collection date for primary outcome measure)|
No Intervention: Control
Standard post ED care
Experimental: 2-3 day return appointment
Patients will receive further treatment in Geriatric Clinic 2-3 days post ED discharge.
Other: 2-3 day return appointment
2-3 appointment in geriatric clinic following ED discharge
|United States, North Carolina|
|Chapel Hill, North Carolina, United States, 27599|
|Principal Investigator:||John S Kizer, MD||UNC Chapel Hill, NC|