{"id":3162,"date":"2020-12-03T00:00:00","date_gmt":"2020-12-03T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/diagnostic-testing-in-long-term-care-and-resident-emergency-department-visits-a-retrospective-cohort-study\/"},"modified":"2023-06-14T19:36:30","modified_gmt":"2023-06-14T23:36:30","slug":"diagnostic-testing-in-long-term-care-and-resident-emergency-department-visits-a-retrospective-cohort-study","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/diagnostic-testing-in-long-term-care-and-resident-emergency-department-visits-a-retrospective-cohort-study\/","title":{"rendered":"Diagnostic testing in long-term care and resident emergency department visits: a retrospective cohort study"},"content":{"rendered":"<p><strong>Objectives<\/strong> &#x2014; To investigate the association between rapid access to radiographs, blood tests, urine cultures, and intravenous (IV) therapy in a long-term care (LTC) home with resident transfers to the emergency department (ED).<\/p>\n<p><strong>Design<\/strong> &#x2014; Retrospective cohort study.<\/p>\n<p><span class=\"bold\">Setting and Participants<\/span> &#x2014; 21,811 residents living in 162 LTC homes in Ontario, Canada.<\/p>\n<p><strong>Methods<\/strong> &#x2014; We administered a survey to LTC homes to collect wait times for radiographs, basic blood tests, urine culture, and IV therapy. Rapid availability was defined as typically receiving test results within 1 or 2 days, or same-day IV therapy. We linked the survey results to administrative data and defined a cohort of residents living in survey-respondent homes between January and May 2017. We followed residents in the linked administrative databases for 6 months, until discharge, or death. Two physicians identified diagnostic codes for ED visits that were potentially preventable with rapid availability of each of the 4 resources. Multilevel logistic regression models estimated associations between potentially preventable ED visits and rapid diagnostic tests and intravenous access while controlling for demographic characteristics, illness severity, LTC home size, chain status, and physician availability.<\/p>\n<p><strong>Results<\/strong> &#x2014; Rapid blood tests, radiographs, urine culture, and IV therapy were available in 55%, 47%, 34%, and 45% of LTC homes, respectively. LTC homes that were part of multihome chains were less likely to have rapid access to the 4 resources. Of the 4736 residents (27%) who visited an ED during follow-up, individuals from homes with rapid access to radiographs (odds ratio 0.79, 95% confidence interval 0.66-0.97), urine culture (0.88, 0.72-1.08), blood tests (0.83, 0.69-1.00), and IV therapy (0.93, 0.70-1.23) tended to have fewer potentially preventable ED visits.<\/p>\n<p><span class=\"bold\">Conclusions and Implications<\/span> &#x2014; Rapid access to diagnostic testing and IV therapy in LTC reduced ED visits. Improving access to these resources may prevent ED visits and allow residents to stay home.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Objectives &#x2014; To investigate the association between rapid access to radiographs, blood tests, urine cultures, and intravenous (IV) therapy in a long-term care (LTC) home with resident transfers to the emergency department (ED). Design &#x2014; Retrospective cohort study. Setting and Participants &#x2014; 21,811 residents living in 162 LTC homes in Ontario, Canada. Methods &#x2014; We [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-3162","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Kunkel E, Tanuseputro P, Hsu A, Talarico R, Lapenskie J, Calder-Sprackman S, Kobewka D. <em>J Am Med Dir Assoc<\/em>. 2021; 22(4):901-6.e4. Epub 2020 Dec 3.","source_url":"https:\/\/doi.org\/10.1016\/j.jamda.2020.09.043","ices_scientist":[1107,1141],"site":[6734],"research_program":[],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[9371],"video":[],"downloads":null,"links":null,"sitecore_item_id":"C6E6AE22-2865-4F07-B04A-5335787578AF","sitecore_item_name":"Diagnostic-testing-in-long-term-care-and-resident-emergency-department-visits-a-retrospective-cohort","sitecore_field_values":"{\n  \"__Valid from\": \"20201203T121650\",\n  \"Title\": \"Diagnostic testing in long-term care and resident emergency department visits: a retrospective cohort study\",\n  \"Short title\": \"Diagnostic testing in long-term care\",\n  \"Summary\": \"Rapid access to diagnostic testing and IV therapy in LTC reduced ED visits. Improving access to these resources may prevent ED visits and allow residents to stay home.\",\n  \"Citation\": \"<p>Kunkel E, Tanuseputro P, Hsu A, Talarico R, Lapenskie J, Calder-Sprackman S, Kobewka D. <em>J Am Med Dir Assoc<\/em>. 2021; 22(4):901-6.e4. Epub 2020 Dec 3. DOI: <a href=\"https:\/\/doi.org\/10.1016\/j.jamda.2020.09.043\" title=\"opens external link\">https:\/\/doi.org\/10.1016\/j.jamda.2020.09.043<\/a><\/p>\",\n  \"Abstract\": \"<p><strong>Objectives<\/strong> &mdash; To investigate the association between rapid access to radiographs, blood tests, urine cultures, and intravenous (IV) therapy in a long-term care (LTC) home with resident transfers to the emergency department (ED).<\/p>n<p><strong>Design<\/strong> &mdash; Retrospective cohort study.<\/p>n<p><span class=\"bold\">Setting and Participants<\/span> &mdash; 21,811 residents living in 162 LTC homes in Ontario, Canada.<\/p>n<p><strong>Methods<\/strong> &mdash; We administered a survey to LTC homes to collect wait times for radiographs, basic blood tests, urine culture, and IV therapy. Rapid availability was defined as typically receiving test results within 1 or 2 days, or same-day IV therapy. We linked the survey results to administrative data and defined a cohort of residents living in survey-respondent homes between January and May 2017. We followed residents in the linked administrative databases for 6 months, until discharge, or death. Two physicians identified diagnostic codes for ED visits that were potentially preventable with rapid availability of each of the 4 resources. Multilevel logistic regression models estimated associations between potentially preventable ED visits and rapid diagnostic tests and intravenous access while controlling for demographic characteristics, illness severity, LTC home size, chain status, and physician availability.<\/p>n<p><strong>Results<\/strong> &mdash; Rapid blood tests, radiographs, urine culture, and IV therapy were available in 55%, 47%, 34%, and 45% of LTC homes, respectively. LTC homes that were part of multihome chains were less likely to have rapid access to the 4 resources. Of the 4736 residents (27%) who visited an ED during follow-up, individuals from homes with rapid access to radiographs (odds ratio 0.79, 95% confidence interval 0.66-0.97), urine culture (0.88, 0.72-1.08), blood tests (0.83, 0.69-1.00), and IV therapy (0.93, 0.70-1.23) tended to have fewer potentially preventable ED visits.<\/p>n<p><span class=\"bold\">Conclusions and Implications<\/span> &mdash; Rapid access to diagnostic testing and IV therapy in LTC reduced ED visits. Improving access to these resources may prevent ED visits and allow residents to stay home.<\/p>\",\n  \"Research Programs\": \"{5B1AF319-EC9B-4BF0-A9CD-D066ABE49D71}\",\n  \"ICES Locations\": \"{0AD77E2C-C883-4E93-8B9A-40B82D50E3A5}\",\n  \"ICES Scientists\": \"{B9979611-1657-47B5-B80F-08815BA48831}|{B0380E31-7F06-498A-B2AB-6AE853CA8C7E}\",\n  \"Posted Date\": \"20201203T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2020\/December\/Diagnostic-testing-in-long-term-care-and-resident-emergency-department-visits-a-retrospective-cohort"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Diagnostic testing in long-term care and resident emergency department visits: a retrospective cohort study<\/title>\n<meta name=\"description\" content=\"Objectives &#x2014; To investigate the association between rapid access to radiographs, blood tests, urine cultures, and intravenous (IV) therapy in a\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/diagnostic-testing-in-long-term-care-and-resident-emergency-department-visits-a-retrospective-cohort-study\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | Diagnostic testing in long-term care and resident emergency department visits: a retrospective cohort study\" \/>\n<meta property=\"og:description\" content=\"Objectives &#x2014; 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