Unscheduled emergency department presentations with diabetes: Identifying high risk characteristics.

Gale, J; Varndell, W; James, S; Perry, L

Unscheduled emergency department presentations with diabetes: Identifying high risk characteristics.

Gale, J Varndell, W

James, S Perry, L

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Publisher:: Elsevier
Publication Type:: Journal Article
Citation:: Australas Emerg Care, 2023, pp. S2588-994X(22)00092-6
Issue Date:: 2023

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Field	Value	Language
dc.contributor.author	Gale, J
dc.contributor.author	Varndell, W https://orcid.org/0000-0002-4752-9679
dc.contributor.author	James, S
dc.contributor.author	Perry, L https://orcid.org/0000-0002-8507-1283
dc.date.accessioned	2023-06-27T21:28:34Z
dc.date.available	2022-12-07
dc.date.available	2023-06-27T21:28:34Z
dc.date.issued	2023
dc.identifier.citation	Australas Emerg Care, 2023, pp. S2588-994X(22)00092-6
dc.identifier.issn	2589-1375
dc.identifier.issn	2588-994X
dc.identifier.uri	http://hdl.handle.net/10453/170905
dc.description.abstract	BACKGROUND: Unscheduled emergency department (ED) presentation by patients with diabetes has seldom been examined. This study aimed to determine the frequency and associated characteristics of presentations in this population. METHODS: Using a prospective cross-sectional design, data were collected from patients with diabetes presenting and/or admitted to a tertiary metropolitan hospital in New South Wales, Australia (December 2016-September 2017). A screening interview including brief measures of cognitive and executive function, and clinical details from healthcare records were utilised; details around unscheduled presentations within 90 days were extracted. Independent associations with ED presentation were determined. RESULTS: Unscheduled ED presentations were common; 35.4% had at least one within 90 days, and for 20.1% this occurred within 28 days. The screening tool contributed little towards identifying risk of unscheduled presentation. Those attending any community or outpatient follow-up appointment within the first 28 (OR 0.42, 95% CI 0.23-0.76; p = 0.004) or 90 days (OR 0.25; 0.13-0.47; p < 0.001) from the index presentation were less likely to present within that same period. CONCLUSIONS: Findings indicated the magnitude of unscheduled ED presentation, care complexity and the value of targeted and timely follow-up. Alternative service support may help maintain and improve diabetes self-management and will require effectiveness and cost-effectiveness evaluation.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Elsevier
dc.relation.ispartof	Australas Emerg Care
dc.relation.isbasedon	10.1016/j.auec.2022.12.001
dc.rights	info:eu-repo/semantics/closedAccess
dc.title	Unscheduled emergency department presentations with diabetes: Identifying high risk characteristics.
dc.type	Journal Article
utslib.location.activity	Australia
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2023-06-27T21:28:33Z
pubs.publication-status	Published online

Abstract:

BACKGROUND: Unscheduled emergency department (ED) presentation by patients with diabetes has seldom been examined. This study aimed to determine the frequency and associated characteristics of presentations in this population. METHODS: Using a prospective cross-sectional design, data were collected from patients with diabetes presenting and/or admitted to a tertiary metropolitan hospital in New South Wales, Australia (December 2016-September 2017). A screening interview including brief measures of cognitive and executive function, and clinical details from healthcare records were utilised; details around unscheduled presentations within 90 days were extracted. Independent associations with ED presentation were determined. RESULTS: Unscheduled ED presentations were common; 35.4% had at least one within 90 days, and for 20.1% this occurred within 28 days. The screening tool contributed little towards identifying risk of unscheduled presentation. Those attending any community or outpatient follow-up appointment within the first 28 (OR 0.42, 95% CI 0.23-0.76; p = 0.004) or 90 days (OR 0.25; 0.13-0.47; p < 0.001) from the index presentation were less likely to present within that same period. CONCLUSIONS: Findings indicated the magnitude of unscheduled ED presentation, care complexity and the value of targeted and timely follow-up. Alternative service support may help maintain and improve diabetes self-management and will require effectiveness and cost-effectiveness evaluation.

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http://hdl.handle.net/10453/170905