{"id":4275,"date":"2015-04-30T00:00:00","date_gmt":"2015-04-30T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/incident-atrial-fibrillation-in-the-emergency-department-in-ontario-a-population-based-retrospective-cohort-study-of-follow-up-care\/"},"modified":"2023-06-14T20:06:26","modified_gmt":"2023-06-15T00:06:26","slug":"incident-atrial-fibrillation-in-the-emergency-department-in-ontario-a-population-based-retrospective-cohort-study-of-follow-up-care","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/incident-atrial-fibrillation-in-the-emergency-department-in-ontario-a-population-based-retrospective-cohort-study-of-follow-up-care\/","title":{"rendered":"Incident atrial fibrillation in the emergency department in Ontario: a population-based retrospective cohort study of follow-up care"},"content":{"rendered":"

Background <\/strong>— Continuity of care has been shown to be poor following in-hospital discharge, and there are substantially fewer resources to facilitate follow-up care arrangements after discharge from an emergency department. Our objective was to assess the frequency, timeliness and predictors for obtaining follow-up care following discharge from an emergency department in Ontario with a new diagnosis of atrial fibrillation. <\/p>\n

Methods <\/strong>— We conducted a retrospective cohort study involving all patients discharged from the 157 nonpediatric emergency departments in Ontario, who received a new diagnosis of atrial fibrillation between 2007 and 2012. We determined the frequency of follow-up care with a family physician, cardiologist or internist within 7 (timely) and 30 days of the emergency department visit, and assessed the association of emergency and family physician characteristics, including primary care model type, with obtaining timely follow-up care. <\/p>\n

Results <\/strong>— Among 14 907 patients discharged from Ontario emergency departments with a new, primary diagnosis of atrial fibrillation, half (n = 7473) had timely follow-up care. At 30 days, 2678 patients (18.0%) still had not obtained follow-up care. Among emergency and family physician factors, lack of a family physician had the largest independent association with acquiring timely follow-up care (odds ratio [OR] 0.58, 95% confidence interval [CI] 0.50–0.69). Using patients with a family physician belonging to a primarily fee-for-service remuneration model as the comparison group, patients with a family physician belonging to a capitation-based Family Health Network, as part of a Family Health Team, were less likely to receive timely follow-up care (OR 0.73, 95% CI 0.62–0.86), as were those whose family physician belonged to the same model type that was not part of a Family Health Team (OR 0.77, 95% CI 0.60–0.97). <\/p>\n

Interpretation<\/strong> — Only half of the patients who were discharged from an emergency department in Ontario with a new diagnosis of atrial fibrillation were seen within 7 days of discharge. The most influential factor was having a family physician; patients with a family physician being remunerated via primarily fee-for-service methods were more likely to be seen within 7 days than those who were reimbursed through a primarily capitation model. Systems-wide solutions are needed to ensure timely follow-up care is available for all patients with chronic diseases.<\/p>\n","protected":false},"excerpt":{"rendered":"

Background — Continuity of care has been shown to be poor following in-hospital discharge, and there are substantially fewer resources to facilitate follow-up care arrangements after discharge from an emergency department. Our objective was to assess the frequency, timeliness and predictors for obtaining follow-up care following discharge from an emergency department in Ontario with a […]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[24,40,28],"migration-helper-qa-sample-set":[],"class_list":["post-4275","journal_article","type-journal_article","status-publish","hentry","topic-acute-and-emergency-services","topic-cardiovascular-disease","topic-primary-care"],"acf":{"citation":"Atzema CL, Yu B, Ivers N, Rochon P, Lee DS, Schull MJ, Austin PC. CMAJ Open.<\/em> 2015; 3(2): E182-91.","source_url":"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4565173\/","ices_scientist":[1383,1273,1340,1290,1368,1385],"site":[6733,6735],"research_program":[6742,6746],"news_release":[7819],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"3738D082-74D2-48A2-BCE6-DAFA13D32BE6","sitecore_item_name":"Incident-atrial-fibrillation-in-the-ED-in-Ontario","sitecore_field_values":"{\n \"__Valid from\": \"20170726T155742\",\n \"Title\": \"Incident atrial fibrillation in the emergency department in Ontario: a population-based retrospective cohort study of follow-up care\",\n \"Short title\": \"Incident atrial fibrillation\",\n \"Summary\": \"Only half of the patients who were discharged from an emergency department in Ontario with a new diagnosis of atrial fibrillation were seen within 7 days of discharge.\",\n \"Citation\": \"

Atzema CL, Yu B, Ivers N, Rochon P, Lee DS, Schull MJ, Austin PC. CMAJ Open.<\/em> 2015; 3(2): E182-91.<\/p>\",\n \"Abstract\": \"

Background <\/strong>— Continuity of care has been shown to be poor following in-hospital discharge, and there are substantially fewer resources to facilitate follow-up care arrangements after discharge from an emergency department. Our objective was to assess the frequency, timeliness and predictors for obtaining follow-up care following discharge from an emergency department in Ontario with a new diagnosis of atrial fibrillation. <\/p>n

Methods <\/strong>— We conducted a retrospective cohort study involving all patients discharged from the 157 nonpediatric emergency departments in Ontario, who received a new diagnosis of atrial fibrillation between 2007 and 2012. We determined the frequency of follow-up care with a family physician, cardiologist or internist within 7 (timely) and 30 days of the emergency department visit, and assessed the association of emergency and family physician characteristics, including primary care model type, with obtaining timely follow-up care. <\/p>n

Results <\/strong>— Among 14 907 patients discharged from Ontario emergency departments with a new, primary diagnosis of atrial fibrillation, half (n = 7473) had timely follow-up care. At 30 days, 2678 patients (18.0%) still had not obtained follow-up care. Among emergency and family physician factors, lack of a family physician had the largest independent association with acquiring timely follow-up care (odds ratio [OR] 0.58, 95% confidence interval [CI] 0.50–0.69). Using patients with a family physician belonging to a primarily fee-for-service remuneration model as the comparison group, patients with a family physician belonging to a capitation-based Family Health Network, as part of a Family Health Team, were less likely to receive timely follow-up care (OR 0.73, 95% CI 0.62–0.86), as were those whose family physician belonged to the same model type that was not part of a Family Health Team (OR 0.77, 95% CI 0.60–0.97). <\/p>n

Interpretation<\/strong> — Only half of the patients who were discharged from an emergency department in Ontario with a new diagnosis of atrial fibrillation were seen within 7 days of discharge. The most influential factor was having a family physician; patients with a family physician being remunerated via primarily fee-for-service methods were more likely to be seen within 7 days than those who were reimbursed through a primarily capitation model. Systems-wide solutions are needed to ensure timely follow-up care is available for all patients with chronic diseases.<\/p>n

View full text<\/a><\/p>\",\n \"Keywords\": \"{8DA96C16-E06B-4D90-802D-73D8A7C9612E}|{C793C025-155C-4E69-BCE7-027408ECD258}|{0072E8A8-FAF8-4B0B-A671-A4F65F7D4D83}\",\n \"Related Products\": \"

News release<\/h2>rn

Only half of patients receive follow-up care within seven days after leaving the ED with new diagnosis of irregular heartbeat <\/a><\/h3>\",\n \"Research Programs\": \"{BEC72DE0-BA8C-42B8-ACE5-EE29FFB2CB3B}|{5B1AF319-EC9B-4BF0-A9CD-D066ABE49D71}|{CFE36C89-C969-4C23-B5E4-1BA9E5BDC273}\",\n \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}|{FBE2D1B1-C0BA-423F-8D16-39466B6C1424}\",\n \"ICES Scientists\": \"{C64B6343-F278-4DA2-B6AC-6717844BC77D}|{29F97D77-F0C4-42C0-8C0B-7297FF488CC8}|{14B76C34-3A35-4785-86C4-9B1633E28765}|{CEEE13AD-C7DE-455F-ACF8-AAD7D27BB178}|{3504EE2C-F0D3-4BEC-8704-14D8CEC924BB}|{7D498E8B-5801-4F9E-AC41-11ED50F3C34E}\",\n \"Posted Date\": \"20150430T131800\",\n \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2015\/January\/Incident-atrial-fibrillation-in-the-ED-in-Ontario"},"yoast_head":"\nICES | Incident atrial fibrillation in the emergency department in Ontario: a population-based 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