Date of Award

January 2022

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Becca Levy

Abstract

Objectives. To develop a framework for as well as examine the relationship between patient-clinician agreement on what matters to older adults in the emergency department (ED) and 30-day ED return visits.Methods. A sample of 45 emergency department patients aged 70+ and their emergency clinicians were separately asked about the patient’s desired outcomes for their ED visit. Thematic analysis of interview transcripts was conducted and dyadic agreement for each of the identified themes was recorded, then a percent agreement composite score was calculated. 30-day ED return visits were tallied and additional sociodemographic and clinical data was accumulated. Descriptive, bivariate, and multivariate analyses were then conducted. Results. The shared desired outcome themes identified were diagnosis, disposition, reassurance, and resolution of symptoms. Within the total sample, 48.9% of patient-clinician dyads had a below acceptable (>75%) level of agreement regarding the desired outcome themes. Out of the 45 participants enrolled in the study, 11 had a 30-day ED return visit. No significant associations were found in bivariate or multivariate logistic regressions. Conclusion. Although no significant associations were found, the importance of and paucity of data surrounding the topic of alignment on what matters and return visits in the ED among older adults and their clinicians was highlighted. A framework was developed that may act as a foundation for further investigation into these potential relationships. More detailed research is necessary and encouraged to learn more about patient priorities for older adults and return visits to the ED.

Comments

This is an Open Access Thesis.

Download
Open Access

This Article is Open Access

Share

COinS