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- W2891152915 abstract "Identifying patients with high-risk potential of discharge failure guides interventions focused on improving patient-centered care. Diverse concepts of discharge failure, such as restricted versus broad discharge failure, in the current literature can make implementing such interventions less efficient. Restricted discharge failure refers to patients who are discharged from the index emergency department (ED) visit and then return to ED within 30 days under non-emergent conditions, whereas broad ED discharge failure refers to patients who discharge from the index ED visit with no outpatient follow-up compliance within 1 year. In this study, we aim to derive a screening tool based on both restricted and broad discharge failure models in order to identify patients who will ultimately have discharge failure, regardless of the type of discharge failure. Data from all ED discharged patients were collected from Jan. 1, 2015 through Dec. 31, 2017 and followed up at least 30-days. Scoring systems were derived using modified Framingham methods. Sensitivity, specificity, and area under the receiver operational characteristic (AUC) were calculated and compared using both the broad and restricted discharge failure models. A total of 227,627 patients were included in the study. Screening for Healthcare follow-Up Tool (SHOUT) scoring systems was derived based on the broad and restricted discharge failure models and applied back to the entire study cohort. A sensitivity of 80% and a specificity of 71% were found in SHOUT scores of equal or more than 9 to identify patients with broad discharge failure with AUC of 0.83 (95% CI 0.83-0.84). When applied to the restricted discharge failure model, a sensitivity of 86% and a specificity of 60% were found to identify patients with AUC of 0.79 (95% CI 0.78-0.80). SHOUT scoring system was derived and used as initial screening to differentiate patients with discharge failures. It can be broadly used to identify this patient population regardless of diverse concepts of discharge failures in the current literature." @default.
- W2891152915 created "2018-09-27" @default.
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- W2891152915 date "2018-10-01" @default.
- W2891152915 modified "2023-09-25" @default.
- W2891152915 title "126 Identifying Diverse Concepts of Discharge Failure With Emergency Department Patients" @default.
- W2891152915 doi "https://doi.org/10.1016/j.annemergmed.2018.08.131" @default.
- W2891152915 hasPublicationYear "2018" @default.
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