Improving emergency department (ED) health services to better match the needs of older adults can be accomplished by providing additional disposition options. When seniors experience an acute change in health, options are often limited to calling 911 or going directly to the ED, which often results in a hospitalization. For complex seniors, there is a risk that limited disposition options carry a risk of cascading to hospital acquired complications. Because 70 percent of admissions for older adults originate in the ED, we sought to introduce an ED-based disposition option for treatment within the comfort and safety of home.
Results and Conclusions
- Pilot process of transitioning seniors from the ED to receive home health care successfully developed and deployed.
- A total of 70 patients received an average of seven home visits over approximately three days.
- High satisfaction among patients, family and care providers, especially with text messaging which offered near real-time interaction with fellow care team members and physicians.
- Costs are significantly lower to Medicare for reimbursement for home health versus a hospitalization.
- Numbers of ED revisits and hospitalizations were not unexpected with 15 ED revisits and 4 hospitalizations.