Evidence map›Paper›PMID 38641801›Full record

Observational studyBMC geriatrics2024

Cost of care pathways before and after appropriate and inappropriate transfers to the emergency department among nursing home residents: results from the FINE study.

E Gombault-Datzenko, N Costa, M Mounié, N Tavassoli, C Mathieu, H Roussel, J M Lagarrigue, E Berard, Y Rolland, L Molinier

Registry-linked trialOpen access · goldAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC geriatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02677272 (Factors Predisposing to Inappropriate Transfers of Nursing Home Residents to Emergency Departments), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
2.5field-weighted citation impact, top 11% of its field
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.

NCT02677272 completednot on this map

Factors Predisposing to Inappropriate Transfers of Nursing Home Residents to Emergency Departments

TypeobservationalSponsorUniversity Hospital, ToulouseRan2016 to 2018Enrolled1,040ConditionsFrail ElderlyArmsAppropriateness of NH resident's transfer to ED
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Trial
  2. Review
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

10 authors at 5 institutions in 1 country.

E Gombault-DatzenkoPresent address: Department of Medical Information (DIM), Toulouse University Hospital, 2 rue Viguerie, Toulouse Cedex 9, 31059, France. gombault.e@chu-toulouse.fr.
N CostaPresent address: Department of Medical Information (DIM), Toulouse University Hospital, 2 rue Viguerie, Toulouse Cedex 9, 31059, France.
M MouniéPresent address: Department of Medical Information (DIM), Toulouse University Hospital, 2 rue Viguerie, Toulouse Cedex 9, 31059, France.
N TavassoliGérontopôle, Toulouse University Hospital, Toulouse, France.
C MathieuGérontopôle, Toulouse University Hospital, Toulouse, France.
H RousselCNAM, DRSM Occitanie, 2 rue Georges Vivent, Toulouse, 31082, France.
J M LagarrigueMSA Midi-Pyrénées Nord, 180 Avenue Marcel Unal, Montauban, 82000, France.
E BerardINSERM, UMR 1295, Toulouse, France.
Y RollandINSERM, UMR 1295, Toulouse, France.
L MolinierPresent address: Department of Medical Information (DIM), Toulouse University Hospital, 2 rue Viguerie, Toulouse Cedex 9, 31059, France.
Inserm · FRMédipole Garonne · FRConservatoire National des Arts et Métiers · FRUniversité Fédérale de Toulouse Midi-Pyrénées · FRUniversité Toulouse III - Paul Sabatier · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTransfers of nursing home (NH) residents to the emergency department (ED) is frequent. Our main objective was to assess the cost of care pathways 6 months before and after the transfer to the emergency department among NH residents, according to the type of transfer (i.e. appropriate or inappropriate).

methodsThis was a part of an observational, multicenter, case-control study: the Factors associated with INappropriate transfer to the Emergency department among nursing home residents (FINE) study. Sixteen public hospitals of the former Midi-Pyrénées region participated in recruitment, in 2016. During the inclusion period, all NH residents arriving at the ED were included. A pluri-disciplinary team categorized each transfer to the ED into 2 groups: appropriate or inappropriate. Direct medical and nonmedical costs were assessed from the French Health Insurance (FHI) perspective. Healthcare resources were retrospectively gathered from the FHI database and valued using the tariffs reimbursed by the FHI. Costs were recorded over a 6-month period before and after transfer to the ED. Other variables were used for analysis: sex, age, Charlson score, season, death and presence inside the NH of a coordinating physician or a geriatric nursing assistant.

resultsAmong the 1037 patients initially included in the FINE study, 616 who were listed in the FHI database were included in this economic study. Among them, 132 (21.4%) had an inappropriate transfer to the ED. In the 6 months before ED transfer, total direct costs on average amounted to 8,145€ vs. 6,493€ in the inappropriate and appropriate transfer groups, respectively. In the 6 months after ED transfer, they amounted on average to 9,050€ vs. 12,094€.

conclusionsTotal costs on average are higher after transfer to the ED, but there is no significant increase in healthcare expenditure with inappropriate ED transfer. Support for NH staff and better pathways of care could be necessary to reduce healthcare expenditures in NH residents.

trial registrationclinicaltrials.gov, NCT02677272.

Indexed as

Critical PathwaysNursing HomesAgedCase-Control StudiesEmergency Service, HospitalHumansPatient TransferRetrospective StudiesCostEconomicsLong-term care unitNursing homeTransfer to emergency department

Identifiers

PMID38641801
PMCPMC11027376
OpenAlexW4394954547

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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.