Australian health review : a publication of the Australian Hospital Association
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Local trends in emergency department attendances by older patients in an ageing national population.
Nursing-led aged care services were set up at our Emergency Department (ED) in 2004-05 to assist in the appropriate discharge of older patients. This study examined local trends in ED attendances by older patients. A retrospective study was conducted at an inner-city adult ED in a region with a 2.2% annual growth rate. ⋯ This decrease in ED attendances by older patients was unexpected. This may represent local population trends and/or be related to ED services designed to manage older patients and nursing home residents in the community. The planning of health services for older people therefore needs to take into consideration the influences on local trends in changing population demographics.
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We sought to examine potential predictors of readmission after coronary artery bypass graft (CABG) surgery. ⋯ 7.1%, 15.2%, and 32.3% of the study population were readmitted at 7 days, 30 days and 6 months respectively. In a multivariable regression model Charlson comorbidity index was associated with 30-day (OR = 1.18; 95% CI 1.11-1.24; P < 0.01) and 6-month readmission (OR = 1.20; 95% CI 1.15-1.26; P < 0.01). Multiple ED visits were associated with 7 day (OR = 1.75; 95% CI 1.28-2.38; P < 0.01), 30 day (OR = 1.53; 95% CI 1.22-1.93; P < 0.01) and 6 month (OR = 1.80; 95% CI 1.49-2.18; P < 0.01) readmission. Waiting time was not a statistically significant predictor of readmission.
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To describe the epidemiological and other characteristics of emergency department (ED) presentations diagnosed with acute upper respiratory infection (URI). ⋯ Further investigation is needed into whether alternative medical care services would be appropriate and acceptable for patients with less severe acute URIs.
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The establishment of the Grampians After-Hours Service has led to the development of a quality framework for nurse telephone triage. The service providers believe this framework is the basis for the service's success. ⋯ It also involves a continuous and non-punitive quality review process that operates at the individual, small group, organisation and whole-system level. The framework will continue to improve and at this time provides a foundation for discussion and further application in the pursuit of quality improvement in rural after-hours health services.