Evidence map›Paper›PMID 39246624›Full record

ArticleJournal of geriatric emergency medicine2024

Frailty Explains Variation in Emergency Department Use for Older Veterans During the COVID-19 Pandemic.

Justine Seidenfeld, Karen M Stechuchak, Valerie A Smith, Catherine Stanwyck, Chelsea Perfect, Courtney Van Houtven, Susan Nicole Hastings

Abstract read
In one paragraph

Article in Journal of geriatric emergency medicine, 2024. 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

7 authors.

Justine SeidenfeldCenter of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, USA.
Karen M StechuchakCenter of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, USA.
Valerie A SmithCenter of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, USA.
Catherine StanwyckCenter of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, USA.
Chelsea PerfectDepartment of Medicine, Duke University School of Medicine, Durham, NC, USA.
Courtney Van HoutvenCenter for the Study of Human Aging and Development, Duke University School of Medicine, Durham, NC, USA.
Susan Nicole HastingsCenter of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, USA.

Funding

Quality of Care and Patient Experience in GeriPACT: A Comparative Effectiveness StudyI01HX002039 · VA · DURHAM VA MEDICAL CENTER · PI HASTINGS, SUSAN NICOLE, VAN HOUTVEN, COURTNEY HAROLD · 2019 to 2025
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A Shared Decision-Making Tool to Support Emergency Department Dispositions for Veterans with DementiaIK2HX003673 · VA · DURHAM VA MEDICAL CENTER · PI Justine Seidenfeld · 2024 to 2026
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HSRD VA I01 HX002039HSRD VA IK2 HX003673
6 · The paper itself

Abstract

Introduction: Older adults were critically vulnerable to disruptions in health care during the COVID-19 pandemic, but it is not known if changes in ED utilization varied based on patient characteristics. Using a cohort of older Veterans, we examined changes in ED visit rates based on four characteristics of interest: age, race, area deprivation index, and frailty. Methods: Participants were aged ≥65, with ≥2 visits in primary or geriatric clinics between 02/02/2018-05/07/2019. An adjusted negative binomial regression model was constructed for each characteristic. We report mean counts of all ED visits by quarter for subgroups separately, and report rate ratios to compare ED visits in the first year of the COVID-19 pandemic to the year before. Results: Patients with complete case data numbered 38,871. During the first two quarters, all subgroups had decreased ED visits, with more variation in the third and fourth quarters. The very highly frail, who had the highest mean estimated count of ED visits per person through both pre-COVID and COVID periods, also had a significant decrease in their ED visits during multiple quarters of the pandemic to a greater degree than other frailty subgroups. Conclusion: Stratifying older adults by frailty identified patient subgroups with the greatest variation in ED visits during COVID. Very highly frail patients warrant special attention to understand how variation in ED utilization affects patient outcomes.

Indexed as

acute care utilizationCOVID-19emergency medicinefrailtyVeteran Health Affairs

Identifiers

PMID39246624
PMCPMC11378967

What OpenQuestion holds

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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.