Low-Income Senior Housing Residents' Emergency Department Use and Care Transition Problems

J Pharm Pract. 2018 Dec;31(6):610-616. doi: 10.1177/0897190017734763. Epub 2017 Oct 8.

Abstract

Older adults may be at risk of adverse outcomes after emergency department (ED) visits due to ineffective transitions of care. Semi-structured interviews were employed to identify and categorize reasons for ED use and problems that occur during transition from the ED back to home among 14 residents of low-income senior housing. Qualitative thematic and descriptive analyses were used. Ambulance use, timely ED use or a wait-and-see approach, and lack of health-care provider contact before ED visit were emergent themes. Delayed medication receipt, no current medication list, and medication knowledge gaps were identified. Lack of a personal health record, follow-up care instruction, and worsening symptoms education emerged as transition problems from ED to home. After an ED visit, education opportunities exist around seeing primary care providers for nonurgent conditions, follow-up care, medications, and worsening condition symptoms. Timely receipt of discharge medications and medication education may improve medication-related transition problems.

Keywords: care transitions; discharge medication; emergency department use; older adults; senior housing.

MeSH terms

  • Adult
  • Aged
  • Emergency Service, Hospital / economics*
  • Emergency Service, Hospital / organization & administration*
  • Emergency Service, Hospital / standards
  • Female
  • Housing / economics
  • Housing / organization & administration
  • Housing / standards
  • Humans
  • Male
  • Middle Aged
  • Patient Discharge / economics
  • Patient Satisfaction
  • Patient Transfer / economics*
  • Patient Transfer / methods*
  • Patient Transfer / standards
  • Primary Health Care