Evidence map›Paper›PMID 35930579›Full record

ArticlePloS one2022

Emergency provider perspectives on facilitators and barriers to home and community services for older adults with serious life limiting illness: A qualitative study.

Jacob D Hill, Claire De Forcrand, Allison M Cuthel, Oluwaseun John Adeyemi, Amanda J Shallcross, Corita R Grudzen

Abstract read
In one paragraph

Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Jacob D HillRonald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, New York, New York, United States of America.ORCID 0000-0002-9695-2166
Claire De ForcrandSchool of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, United States of America.
Allison M CuthelRonald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, New York, New York, United States of America.
Oluwaseun John AdeyemiRonald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, New York, New York, United States of America.
Amanda J ShallcrossDepartment of Population Health, New York University Grossman School of Medicine, New York, New York, United States of America.
Corita R GrudzenRonald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, New York, New York, United States of America.

Funding

NIH Health Care Systems Research Collaboratory-Coordinating Center (U24)U24AT009676 · NCCIH · DUKE UNIVERSITY · PI LESLEY H CURTIS, Adrian Hernandez · 2017 to 2026
$21.5M
Primary Palliative Care for Emergency MedicineUH3AT009844 · NCCIH · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI GOLDFELD, KEITH, GRUDZEN, CORITA R · 2019 to 2022
$7.9M
Primary Palliative Care for Emergency MedicineUG3AT009844 · NCCIH · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI GRUDZEN, CORITA R · 2018 to 2018
$984k
NCCIH NIH HHS U24 AT009676NCCIH NIH HHS UG3 AT009844NCCIH NIH HHS UH3 AT009844
6 · The paper itself

Abstract

backgroundOlder adults account for a large proportion of emergency department visits, but those with serious life-limiting illness may benefit most from referral to home and community services instead of hospitalization. We aim to document emergency provider perspectives on facilitators and barriers to accessing home and community services for older adults with serious life-limiting illness.

methodsWe conducted interviewer-administered semi-structured interviews with emergency providers from health systems across the United States to obtain provider perspectives on facilitators and barriers to accessing home and community services. We completed qualitative thematic analysis using an iterative process to develop themes and subthemes to summarize provider responses.

resultsWe interviewed 8 emergency nurses and 10 emergency physicians across 11 health systems. Emergency providers were familiar with local home and community services. Facilitators to accessing these services include care management and social workers. Barriers include services that are not accessible full-time to receive referrals, insurance/payment, and the busy nature of the emergency department. The most helpful reported services were hospice, physical therapy, occupational therapy, and visiting nursing services. Home-based palliative care and full-time emergency department-based care management and social work were the services most desired by providers. Providers expressed support for improving access to home and community services in the hopes of decreasing unnecessary emergency visits and inpatient admissions, and to provide patients with greater options for supportive care.

conclusionObtaining the perspective of emergency providers highlights important considerations to accessing HCS for older-adults with serious life-limiting illness from the emergency department. This study provides foundational information for futures studies and initiatives for improving access to home and community services directly from the emergency department.

Indexed as

Hospice CareAgedHumansPalliative CareQualitative ResearchReferral and ConsultationSocial WelfareUnited States

Identifiers

PMID35930579
PMCPMC9355176

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.