Format

Send to

Choose Destination
BMC Health Serv Res. 2017 Apr 18;17(1):282. doi: 10.1186/s12913-017-2196-1.

Healthcare utilization in older patients using personal emergency response systems: an analysis of electronic health records and medical alert data : Brief Description: A Longitudinal Retrospective Analyses of healthcare utilization rates in older patients using Personal Emergency Response Systems from 2011 to 2015.

Author information

1
Partners Connected Health, Partner Healthcare, 25 New Chardon St., Suite 300, Boston, MA, 02114, USA. sagboola@partners.org.
2
Massachusetts General Hospital, Boston, USA. sagboola@partners.org.
3
Harvard Medical School, Boston, USA. sagboola@partners.org.
4
Partners Connected Health, Partner Healthcare, 25 New Chardon St., Suite 300, Boston, MA, 02114, USA.
5
Massachusetts General Hospital, Boston, USA.
6
Philips, Eindhoven, Netherlands.
7
Harvard Medical School, Boston, USA.

Abstract

BACKGROUND:

Personal Emergency Response Systems (PERS) are traditionally used as fall alert systems for older adults, a population that contributes an overwhelming proportion of healthcare costs in the United States. Previous studies focused mainly on qualitative evaluations of PERS without a longitudinal quantitative evaluation of healthcare utilization in users. To address this gap and better understand the needs of older patients on PERS, we analyzed longitudinal healthcare utilization trends in patients using PERS through the home care management service of a large healthcare organization.

METHODS:

Retrospective, longitudinal analyses of healthcare and PERS utilization records of older patients over a 5-years period from 2011-2015. The primary outcome was to characterize the healthcare utilization of PERS patients. This outcome was assessed by 30-, 90-, and 180-day readmission rates, frequency of principal admitting diagnoses, and prevalence of conditions leading to potentially avoidable admissions based on Centers for Medicare and Medicaid Services classification criteria.

RESULTS:

The overall 30-day readmission rate was 14.2%, 90-days readmission rate was 34.4%, and 180-days readmission rate was 42.2%. While 30-day readmission rates did not increase significantly (p = 0.16) over the study period, 90-days (p = 0.03) and 180-days (p = 0.04) readmission rates did increase significantly. The top 5 most frequent principal diagnoses for inpatient admissions included congestive heart failure (5.7%), chronic obstructive pulmonary disease (4.6%), dysrhythmias (4.3%), septicemia (4.1%), and pneumonia (4.1%). Additionally, 21% of all admissions were due to conditions leading to potentially avoidable admissions in either institutional or non-institutional settings (16% in institutional settings only).

CONCLUSIONS:

Chronic medical conditions account for the majority of healthcare utilization in older patients using PERS. Results suggest that PERS data combined with electronic medical records data can provide useful insights that can be used to improve health outcomes in older patients.

PMID:
28420358
PMCID:
PMC5395921
DOI:
10.1186/s12913-017-2196-1
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for BioMed Central Icon for PubMed Central
Loading ...
Support Center