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Article

Feasibility of Using a Risk Assessment Tool to Predict Hospital Transfers or Death for Older People in Australian Residential Aged Care. A Retrospective Cohort Study

1
Medical School, The University of New South Wales, Kensington 2052, Australia
2
School of Population Health, Faculty of Medicine, University of New South Wales, Kensington 2052, Australia
3
School of Psychology, Faculty of Science, University of New South Wales, Kensington 2052, Australia
4
Uniting (Aged Care Services), Sydney 2067, Australia
5
Agency for Clinical Innovation, St Leonards 2065, Australia
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Intensive Care Unit, Liverpool Hospital, Liverpool 2170, Australia
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Western Sydney Local Health District, North Parramatta 2151, Australia
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Institute for Evidence-Based Healthcare, Bond University, Gold Coast 4226, Australia
9
EBP Professorial Unit, Gold Coast University Hospital, Southport 4215, Australia
*
Author to whom correspondence should be addressed.
Healthcare 2020, 8(3), 284; https://doi.org/10.3390/healthcare8030284
Received: 20 July 2020 / Revised: 18 August 2020 / Accepted: 18 August 2020 / Published: 21 August 2020
(This article belongs to the Special Issue Improving Management and Decision-Making Near End of Life)
Residents of Aged Care Facilities (RACF) experience burdensome hospital transfers in the last year of life, which may lead to aggressive and potentially inappropriate hospital treatments. Anticipating these transfers by identifying risk factors could encourage end-of-life discussions that may change decisions to transfer. The aim was to examine the feasibility of identifying an end-of-life risk profile among RACF residents using a predictive tool to better anticipate predictors of hospital transfers, death or poor composite outcome of hospitalisation and/or death after initial assessment. A retrospective cohort study of 373 permanent residents aged 65+ years was conducted using objective clinical factors from records in nine RACFs in metropolitan Sydney, Australia. In total, 26.8% died and 34.3% experienced a composite outcome. Cox proportional hazard regression models confirmed the feasibility of estimating the level of risk for death or a poor composite outcome. Knowing this should provide opportunities to initiate advance care planning in RACFs, facilitating decision making near the end of life. We conclude that the current structure of electronic RACF databases could be enhanced to enable comprehensive assessment of the risk of hospital re-attendance without admission. Automation tools to facilitate the risk score calculation may encourage the adoption of prediction checklists and evaluation of their association with hospital transfers. View Full-Text
Keywords: residential aged care; risk factors; advance care planning; hospital transfers; end of life residential aged care; risk factors; advance care planning; hospital transfers; end of life
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MDPI and ACS Style

Ooi, M.; Lewis, E.T.; Brisbane, J.; Tubb, E.; McClean, T.; Assareh, H.; Hillman, K.; Achat, H.; Cardona, M. Feasibility of Using a Risk Assessment Tool to Predict Hospital Transfers or Death for Older People in Australian Residential Aged Care. A Retrospective Cohort Study. Healthcare 2020, 8, 284. https://doi.org/10.3390/healthcare8030284

AMA Style

Ooi M, Lewis ET, Brisbane J, Tubb E, McClean T, Assareh H, Hillman K, Achat H, Cardona M. Feasibility of Using a Risk Assessment Tool to Predict Hospital Transfers or Death for Older People in Australian Residential Aged Care. A Retrospective Cohort Study. Healthcare. 2020; 8(3):284. https://doi.org/10.3390/healthcare8030284

Chicago/Turabian Style

Ooi, Meidelynn, Ebony T. Lewis, Julianne Brisbane, Evalynne Tubb, Tom McClean, Hassan Assareh, Ken Hillman, Helen Achat, and Magnolia Cardona. 2020. "Feasibility of Using a Risk Assessment Tool to Predict Hospital Transfers or Death for Older People in Australian Residential Aged Care. A Retrospective Cohort Study" Healthcare 8, no. 3: 284. https://doi.org/10.3390/healthcare8030284

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