The impact of the COVID-19 pandemic on transfers between long-term care and emergency departments across Alberta
Abstract Background Long-term care (LTC) was overwhelmingly impacted by COVID-19 and unnecessary transfer to emergency departments (ED) can have negative health outcomes. This study aimed to explore how the COVID-19 pandemic impacted LTC to ED transfers and hospitalizations, utilization of community...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Emergency Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12873-023-00926-3 |
| _version_ | 1797355952463151104 |
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| author | Leanna Wyer Yair Guterman Vivian Ewa Eddy Lang Peter Faris Jayna Holroyd-Leduc |
| author_facet | Leanna Wyer Yair Guterman Vivian Ewa Eddy Lang Peter Faris Jayna Holroyd-Leduc |
| author_sort | Leanna Wyer |
| collection | DOAJ |
| description | Abstract Background Long-term care (LTC) was overwhelmingly impacted by COVID-19 and unnecessary transfer to emergency departments (ED) can have negative health outcomes. This study aimed to explore how the COVID-19 pandemic impacted LTC to ED transfers and hospitalizations, utilization of community paramedics and facilitated conversations between LTC and ED physicians during the first four waves of the pandemic in Alberta, Canada. Methods In this retrospective population-based study, administrative databases were linked to identify episodes of care for LTC residents who resided in facilities in Alberta, Canada. This study included data from January 1, 2018 to December 31, 2021 to capture outcomes prior to the onset of the pandemic and across the first four waves. Individuals were included if they visited an emergency department, received care from a community paramedic or whose care involved a facilitated conversation between LTC and ED physicians during this time period. Results Transfers to ED and hospitalizations from LTC have been gradually declining since 2018 with a sharp decline seen during wave 1 of the pandemic that was greatest in the lowest-priority triage classification (CTAS 5). Community paramedic visits were highest during the first two waves of the pandemic before declining in subsequent waves; facilitated calls between LTC and ED physicians increased during the waves. Conclusions There was a reduction in number of transfers from LTC to EDs and in hospitalizations during the first four waves of the pandemic. This was supported by increased conversations between LTC and ED physicians, but was not associated with increased community paramedic visits. Additional work is needed to explore how programs such as community paramedics and facilitated conversations between LTC and ED providers can help to reduce unnecessary transfers to hospital. |
| first_indexed | 2024-03-08T14:19:38Z |
| format | Article |
| id | doaj.art-e0276da75f404e06a26d7bf10917c10e |
| institution | Directory Open Access Journal |
| issn | 1471-227X |
| language | English |
| last_indexed | 2024-03-08T14:19:38Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Emergency Medicine |
| spelling | doaj.art-e0276da75f404e06a26d7bf10917c10e2024-01-14T12:14:07ZengBMCBMC Emergency Medicine1471-227X2024-01-012411710.1186/s12873-023-00926-3The impact of the COVID-19 pandemic on transfers between long-term care and emergency departments across AlbertaLeanna Wyer0Yair Guterman1Vivian Ewa2Eddy Lang3Peter Faris4Jayna Holroyd-Leduc5Alberta Health ServicesAlberta Health ServicesAlberta Health ServicesAlberta Health ServicesAlberta Health ServicesAlberta Health ServicesAbstract Background Long-term care (LTC) was overwhelmingly impacted by COVID-19 and unnecessary transfer to emergency departments (ED) can have negative health outcomes. This study aimed to explore how the COVID-19 pandemic impacted LTC to ED transfers and hospitalizations, utilization of community paramedics and facilitated conversations between LTC and ED physicians during the first four waves of the pandemic in Alberta, Canada. Methods In this retrospective population-based study, administrative databases were linked to identify episodes of care for LTC residents who resided in facilities in Alberta, Canada. This study included data from January 1, 2018 to December 31, 2021 to capture outcomes prior to the onset of the pandemic and across the first four waves. Individuals were included if they visited an emergency department, received care from a community paramedic or whose care involved a facilitated conversation between LTC and ED physicians during this time period. Results Transfers to ED and hospitalizations from LTC have been gradually declining since 2018 with a sharp decline seen during wave 1 of the pandemic that was greatest in the lowest-priority triage classification (CTAS 5). Community paramedic visits were highest during the first two waves of the pandemic before declining in subsequent waves; facilitated calls between LTC and ED physicians increased during the waves. Conclusions There was a reduction in number of transfers from LTC to EDs and in hospitalizations during the first four waves of the pandemic. This was supported by increased conversations between LTC and ED physicians, but was not associated with increased community paramedic visits. Additional work is needed to explore how programs such as community paramedics and facilitated conversations between LTC and ED providers can help to reduce unnecessary transfers to hospital.https://doi.org/10.1186/s12873-023-00926-3COVID-19Emergency departmentLong-term careCommunity paramedics |
| spellingShingle | Leanna Wyer Yair Guterman Vivian Ewa Eddy Lang Peter Faris Jayna Holroyd-Leduc The impact of the COVID-19 pandemic on transfers between long-term care and emergency departments across Alberta BMC Emergency Medicine COVID-19 Emergency department Long-term care Community paramedics |
| title | The impact of the COVID-19 pandemic on transfers between long-term care and emergency departments across Alberta |
| title_full | The impact of the COVID-19 pandemic on transfers between long-term care and emergency departments across Alberta |
| title_fullStr | The impact of the COVID-19 pandemic on transfers between long-term care and emergency departments across Alberta |
| title_full_unstemmed | The impact of the COVID-19 pandemic on transfers between long-term care and emergency departments across Alberta |
| title_short | The impact of the COVID-19 pandemic on transfers between long-term care and emergency departments across Alberta |
| title_sort | impact of the covid 19 pandemic on transfers between long term care and emergency departments across alberta |
| topic | COVID-19 Emergency department Long-term care Community paramedics |
| url | https://doi.org/10.1186/s12873-023-00926-3 |
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