International Journal of Gerontology (Jun 2012)

Effectiveness of Comprehensive Geriatric Assessment-Based Intervention to Reduce Frequent Emergency Department Visits: A Report of Four Cases

  • Mei-Chen Liao,
  • Liang-Kung Chen,
  • Meing-Yueh Chou,
  • Chih-Kaung Laing,
  • Yu-Te Lin,
  • Yuk-Keung Lo,
  • Shinn-Jang Hwang,
  • Shue-Ren Wann

DOI
https://doi.org/10.1016/j.ijge.2011.08.003
Journal volume & issue
Vol. 6, no. 2
pp. 131 – 133

Abstract

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A small number of clustered visits by emergency department frequent users (EDFUs) may over-consume emergency care resources. We report the effectiveness of comprehensive geriatric assessment (CGA)-based multidisciplinary team (MDT) care for four EDFUs, in reducing ED visits. Case 1 had visited the ED twice/month due to chest discomfort. Her ED visits were significantly reduced to 0.2 visits/month following CGA-based MDT care. Case 2 had failed back surgery syndrome and bipolar disorder. His ED visit was reduced from 2.8 visits to 0.8 visits/month following CGA-based MDT intervention. Case 3 had chronic obstructive pulmonary disease, heart failure, and urinary incontinence, with a urinary catheter in place. He made 31 ED visits (5.1 visits/month) before his lung cancer and depression were discovered by CGA. He died 2 months later. Case 4 made 27 ED visits (2.7 visits/month) due to dizziness. His problems of early dementia and neglect were identified by CGA, and he visited the ED only once following MDT intervention. In conclusion, CGA-based MDT intervention successfully reduced ED visits among these EDFUs, but further investigation is needed to evaluate the effectiveness of geriatric services in the ED.

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