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Risk of death within 7 days of discharge from emergency departments with different organizational models

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Risk of death within 7 days of discharge from emergency departments with different organizational models. / Møllekær, Anders; Kirkegaard, Hans; Vest Hansen, Betina; Duvald, Iben; Eskildsen, Jacob Kjær; Obel, Børge; Madsen, Bo .

I: European Journal of Emergency Medicine, Bind 27, Nr. 1, 02.2020, s. 27-32.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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@article{fb8ca25553f540b6acdf73fd74d3bd8c,
title = "Risk of death within 7 days of discharge from emergency departments with different organizational models",
abstract = "Objective: The aim of this study is to investigate the association between emergency department (ED) organizational models and the risk of death within 7 days of ED discharge.Patients and methods: We included Danish ED discharges between 1 January 2011 and 24 December 2014 that led to death within 7 days of discharge. The inclusion criterion was age older than 18 years. The exclusion criterion was further in-hospital admission. First model (Virtual): other departments employ interns who perform ED tasks. They are responsible for ED patient care and prioritize their task order between their own department and the ED.Second model (Hybrid): the ED/other departments perform tasks; interns/consultants are employed by the ED/other departments. The ED/other departments have patient care responsibility.Third model (Independent): the ED performs all tasks; employs interns/consultants; and have patient care responsibility.Sex, age, Charlson Comorbidity Index score, and primary diagnosis were used to describe patient characteristics. We calculated the risk of death within 7 days of discharge using multiple logistic regression analysis.Results: In 805 out of 201 299 discharges included in the study, the patient died within 7 days. Compared with the Virtual model, the odds ratio for death within 7 days of discharge was 0.72 (95% confidence interval: 0.59–0.92) for the Independent model and 0.75 (95% confidence interval: 0.61–0.92) for the Hybrid+Virtual model. Increased risk was associated with male sex, older age, and a medium or a high Charlson Comorbidity Index score.Conclusion: Compared with discharges from a Virtual model, the risk of death within 7 days of discharge was lower if the ED had an Independent or a Hybrid+Virtual model.",
author = "Anders M{\o}llek{\ae}r and Hans Kirkegaard and {Vest Hansen}, Betina and Iben Duvald and Eskildsen, {Jacob Kj{\ae}r} and B{\o}rge Obel and Bo Madsen",
year = "2020",
month = feb,
doi = "10.1097/MEJ.0000000000000596",
language = "English",
volume = "27",
pages = "27--32",
journal = "European Journal of Emergency Medicine",
issn = "0969-9546",
publisher = "Lippincott Williams & Wilkins, Ltd.",
number = "1",

}

RIS

TY - JOUR

T1 - Risk of death within 7 days of discharge from emergency departments with different organizational models

AU - Møllekær, Anders

AU - Kirkegaard, Hans

AU - Vest Hansen, Betina

AU - Duvald, Iben

AU - Eskildsen, Jacob Kjær

AU - Obel, Børge

AU - Madsen, Bo

PY - 2020/2

Y1 - 2020/2

N2 - Objective: The aim of this study is to investigate the association between emergency department (ED) organizational models and the risk of death within 7 days of ED discharge.Patients and methods: We included Danish ED discharges between 1 January 2011 and 24 December 2014 that led to death within 7 days of discharge. The inclusion criterion was age older than 18 years. The exclusion criterion was further in-hospital admission. First model (Virtual): other departments employ interns who perform ED tasks. They are responsible for ED patient care and prioritize their task order between their own department and the ED.Second model (Hybrid): the ED/other departments perform tasks; interns/consultants are employed by the ED/other departments. The ED/other departments have patient care responsibility.Third model (Independent): the ED performs all tasks; employs interns/consultants; and have patient care responsibility.Sex, age, Charlson Comorbidity Index score, and primary diagnosis were used to describe patient characteristics. We calculated the risk of death within 7 days of discharge using multiple logistic regression analysis.Results: In 805 out of 201 299 discharges included in the study, the patient died within 7 days. Compared with the Virtual model, the odds ratio for death within 7 days of discharge was 0.72 (95% confidence interval: 0.59–0.92) for the Independent model and 0.75 (95% confidence interval: 0.61–0.92) for the Hybrid+Virtual model. Increased risk was associated with male sex, older age, and a medium or a high Charlson Comorbidity Index score.Conclusion: Compared with discharges from a Virtual model, the risk of death within 7 days of discharge was lower if the ED had an Independent or a Hybrid+Virtual model.

AB - Objective: The aim of this study is to investigate the association between emergency department (ED) organizational models and the risk of death within 7 days of ED discharge.Patients and methods: We included Danish ED discharges between 1 January 2011 and 24 December 2014 that led to death within 7 days of discharge. The inclusion criterion was age older than 18 years. The exclusion criterion was further in-hospital admission. First model (Virtual): other departments employ interns who perform ED tasks. They are responsible for ED patient care and prioritize their task order between their own department and the ED.Second model (Hybrid): the ED/other departments perform tasks; interns/consultants are employed by the ED/other departments. The ED/other departments have patient care responsibility.Third model (Independent): the ED performs all tasks; employs interns/consultants; and have patient care responsibility.Sex, age, Charlson Comorbidity Index score, and primary diagnosis were used to describe patient characteristics. We calculated the risk of death within 7 days of discharge using multiple logistic regression analysis.Results: In 805 out of 201 299 discharges included in the study, the patient died within 7 days. Compared with the Virtual model, the odds ratio for death within 7 days of discharge was 0.72 (95% confidence interval: 0.59–0.92) for the Independent model and 0.75 (95% confidence interval: 0.61–0.92) for the Hybrid+Virtual model. Increased risk was associated with male sex, older age, and a medium or a high Charlson Comorbidity Index score.Conclusion: Compared with discharges from a Virtual model, the risk of death within 7 days of discharge was lower if the ED had an Independent or a Hybrid+Virtual model.

UR - http://www.scopus.com/inward/record.url?scp=85077189509&partnerID=8YFLogxK

U2 - 10.1097/MEJ.0000000000000596

DO - 10.1097/MEJ.0000000000000596

M3 - Journal article

C2 - 30672790

VL - 27

SP - 27

EP - 32

JO - European Journal of Emergency Medicine

JF - European Journal of Emergency Medicine

SN - 0969-9546

IS - 1

ER -