W Weinrebe1, K Kapteina2, R Müller3, E Johannsdottir4, M Karaman5. 1. Zentrum für Frührehabilitation, Campus Spital Hirslanden Bern, Schänzlistr. 31, 3013, Bern, Schweiz. wolfram.weinrebe@hirslanden.ch. 2. Zentrales KH der Bundeswehr, Koblenz, Klinik für Unfallchirurgie, Rübenacherstr. 170, 56072, Koblenz, Deutschland. 3. Zentrum für Frührehabilitation, Campus Spital Hirslanden Bern, Schänzlistr. 31, 3013, Bern, Schweiz. 4. Diak Schwäbisch Hall, Diakoniestr. 10, 74523, Schwäbisch Hall, Deutschland. 5. Institut für Biostatistik Berlin, Naunynstr. 30, 10997, Berlin, Deutschland.
Abstract
BACKGROUND: Lack of clinical management of old patients in the emergency department. QUESTION: How can we manage old patients in the emergency department more effectively, medically and economically? METHODS: Evaluation of current selection and screening methods and recommendations for old patients in the emergency department. Acute inpatient treatment needs, presence of dysfunction in at least two core areas and assessment of advance care needs are examined. RESULT: The identification of old patients in the emergency department as geriatric patients alone shows no control potential. Combining the three test criteria of acute inpatient need for treatment, the presence of dysfunction in at least two core areas and the assessment of advance care needs generates four old patient types that have interesting control potential: the medical traumatology patient, the acute geriatric patient, the rehabilitative geriatric patient, and the ambulatory patient. DISCUSSION: in addition to identifying geriatric patients, screening should map acute inpatient treatment needs, assessment of dysfunction, and analysis of advance care needs to define clinically steerable old patients.
BACKGROUND: Lack of clinical management of old patients in the emergency department. QUESTION: How can we manage old patients in the emergency department more effectively, medically and economically? METHODS: Evaluation of current selection and screening methods and recommendations for old patients in the emergency department. Acute inpatient treatment needs, presence of dysfunction in at least two core areas and assessment of advance care needs are examined. RESULT: The identification of old patients in the emergency department as geriatric patients alone shows no control potential. Combining the three test criteria of acute inpatient need for treatment, the presence of dysfunction in at least two core areas and the assessment of advance care needs generates four old patient types that have interesting control potential: the medical traumatology patient, the acute geriatric patient, the rehabilitative geriatric patient, and the ambulatory patient. DISCUSSION: in addition to identifying geriatric patients, screening should map acute inpatient treatment needs, assessment of dysfunction, and analysis of advance care needs to define clinically steerable old patients.
Authors: J de Gelder; J A Lucke; B de Groot; A J Fogteloo; S Anten; K Mesri; E W Steyerberg; C Heringhaus; G J Blauw; S P Mooijaart Journal: Neth J Med Date: 2016-10 Impact factor: 1.422
Authors: Michael Christ; Florian Grossmann; Daniela Winter; Roland Bingisser; Elke Platz Journal: Dtsch Arztebl Int Date: 2010-12-17 Impact factor: 5.594