Patient-reported outcome and experience measures in geriatric emergency medicine
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Gerontologie+Geriatrie Themenschwerpunkt Z Gerontol Geriat https://doi.org/10.1007/s00391-020-01777-4 Received: 10 July 2020 Accepted: 13 August 2020 © Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2020
James D. van Oppen1,2 · Jose M. Valderas3 · Nicola J. Mackintosh1 · Simon P. Conroy1,2 1
Department of Health Sciences, University of Leicester, Leicester, UK Emergency and Specialist Medicine, University Hospitals Leicester NHS Trust, Leicester, UK 3 Health Services and Policy Research Group, University of Exeter, Exeter, UK 2
Patient-reported outcome and experience measures in geriatric emergency medicine Introduction Older people living with frailty have poorer health outcomes after even short hospital stays [15]. Emergency departments (ED) in most countries have observed annual increases in attendances; around one fifth of people attending German departments are aged over 80 years [26]. In the UK approximately three million annual ED attendances are by people living with frailty. Coordinated efforts are underway to improve healthcare outcomes for older people with frailty and emergency care needs, including through specialised training and focussed research [9]. Traditional fast-flowing, protocoldriven emergency care systems are wellsuited for people with single problems, but may underserve people with atypical presentations or complex comorbidities [2, 21]. Systems tend to require multidisciplinary, holistic, person-centred care in order to best serve people living with frailty [19]. The geriatric emergency medicine sections of the European Society for Emergency Medicine (EUSEM) and the European Union Geriatric Medicine Society (EUGMS) have a shared objective to inform service delivery programmes and research agendas in order to tailor current emergency medicine services for this group [11]. Quality of emergency care for older people is typically reported using service metrics, such as length of stay and readmission rate [5]; however, people living with frailty consider additional metrics
related to health outcomes and preferences for care to also be important and meaningful. Accordingly, the degree to which the provision of care supports patients in reaching their goals as defined around these outcomes and preferences is important for capturing high quality care.
Outcomes and preferences for healthcare Older people with frailty have additional, and perhaps unique needs when they attend the ED [21, 26]. Patient needs can be defined in terms of selected health outcomes or aspects of health status. For older people living with frailty these outcomes include symptoms (mood, pain), functional status (autonomy, activities of daily living, loneliness), survival, quality of life, and carer burden [1, 30]. Individuals’ preferences vary for specific processes and outcomes of health care [18]. Healthcare preferences incorporate the processes or procedures someone is willing to undergo in order to achieve their health outcome goals. Experience of these processes can be determined by individualised care, clinica
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