Improving Continuity of Care Reduces Emergency Department Visits by Long-Term Care Residents

Article Figures & Data

Table 1. Long-term Care Facility Resident Characteristics Pre- and Post-Care by Design

Patient Characteristics	Before Care by Design™^* (n = 203)	After Care by Design™^{^†} (n = 150)	P Value
Age (years), median (IQR)	86.0 (81.0–93.0)	86.0 (79.0–92.0)	.18^{^‡}
Sex
Female	72.9 (148)	79.58 (113)	.47^{^§}
Missing	—	1.41 (2)
Cognitive status			.78^{^‖}
Dementia	57.1 (116)	54.23 (77)
Within normal limits	38.4 (78)	26.76 (38)
Other	1.9 (4)	3.52 (5)
Missing	2.4 (5)	15.49 (22)
Duration of stay in LTCF (years), mean (SD)	5.84 (3.54)	4.5 (2.20)	<.0001^**

Data are % (n) unless otherwise indicated.
↵* September 1, 2008, to January 31, 2009.
↵† September 1, 2010, to January 31, 2011.
↵‡ Wilcoxon rank-sum test.
↵§ χ² Test.
↵‖ χ² Test (rate of dementia).
↵** t Test.
IQR, interquartile range; LTCF, long-term care facility; SD, standard deviation.

Table 3. Physician Care and Continuity in Long-Term Care Facilities

Secondary Outcome Measures (Physician Care and Continuity in LTCFs)	Before Care by Design™^*	After Care by Design™^{^†}	Change (%)	P Value
	Time 1 (n = 164)	Time 2 (n = 142)	Change (%)	P Value
LTCF physician contacted before EHS call (for all residents with a 911 call)	38.4 (63)	53.5 (76)	+15.1	.01^{^‡}
Onsite assessment conducted by a family physician before EHS call (for all residents with a 911 call)	3.7 (6)	9.2 (13)	+5.5	.03^{^‡}
EHS calls that resulted in transports (most recent 911 call only)	94.5 (155)	88.0 (125)	−6.5	.08^{^‡}
Notes in patient charts (only residents living in an LTCF for the full time period), n (%)	Time 1 (n = 138)	Time 2 (n = 97)
0–1	12.3 (17)	3.09 (3)	−9.2	.002^{^‡}
2–9	47.8 (66)	35.1 (34)	−12.7
≥10	37.7 (52)	54.6 (53)	+16.9
Missing	2.2 (3)	7.2 (7)
Notes in patient charts (only residents living in an LTCF for the full time period), median (IQR)	7 (3.0–12.0)	10 (7.0–13.0)		.0026^{^§}

Data are mean (standard deviation).
↵* September 1, 2008, to January 31, 2009.
↵† September 1, 2010, to January 31, 2011.
↵‡ χ² Test.
↵§ Wilcoxon rank-sum test.
EHS, Emergency Health Services; IQR, interquartile range; LTCF, long-term care facility.