Evidence map›Paper›PMID 41632170›Full record

ArticleJAMA network open2025

Home Time Following Emergency Department Visits Among People With Dementia.

Justine Seidenfeld, Lindsay Zepel, Valerie A Smith, Fernanda Bellolio, Anita A Vashi, Courtney H Van Houtven, Susan N Hastings

Abstract read
In one paragraph

Article in JAMA network open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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 Veterans Affairs Health Care System, Durham, North Carolina.
Lindsay ZepelDepartment of Population Health Sciences, School of Medicine, Duke University, Durham, North Carolina.
Valerie A SmithDepartment of Population Health Sciences, School of Medicine, Duke University, Durham, North Carolina.
Fernanda BellolioDepartment of Emergency Medicine, Mayo Clinic, Rochester, Minnesota.
Anita A VashiCenter for Innovation to Implementation, Palo Alto VA Medical Center, Palo Alto, California.
Courtney H Van HoutvenDepartment of Population Health Sciences, School of Medicine, Duke University, Durham, North Carolina.
Susan N HastingsCenter of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, North Carolina.

Funding

Dementia and Value of Home TimeRF1AG072364 · NIA · DUKE UNIVERSITY · PI VAN HOUTVEN, COURTNEY HAROLD · 2021 to 2024
$2.5M
Dementia and Value of Home TimeR01AG072364 · NIA · DUKE UNIVERSITY · PI Courtney Harold Van Houtven · 2025 to 2026
$2.0M
HSRD VA IK2 HX003673NIA NIH HHS R01 AG072364NIA NIH HHS RF1 AG072364
6 · The paper itself

Abstract

Importance: Emergency department (ED) visits for people with dementia often involve care (including the admission or discharge decision) with lasting effects on quality of life. Home time-a claims-based measure of days alive and outside of institutional care-provides a patient-centered way to assess downstream outcomes of ED care in this population. Objective: To examine variations in home time following an ED visit by patient, facility, and visit characteristics among veterans with dementia. Design, Setting, and Participants: This national retrospective cohort study used US Department of Veterans Affairs (VA) health care system data sources. Participants were veterans aged 65 to 110 years with dementia with an eligible Veterans Health Administration ED visit in fiscal years 2017 (October 1, 2016, through September 30, 2017) and/or 2018 (October 1, 2017, through September 30, 2018). Data were analyzed from May 1, 2024, to May 15, 2025. Exposures: Patient, ED facility, and ED visit factors. Main Outcomes and Measures: Home time, operationalized for modeling as days not at home in the 180 days after the index ED visit. Associations between patient, ED facility, and ED visit characteristics and home time were assessed using a negative binomial model. Results: The study included 51 707 veterans with dementia (mean [SD] age, 79.9 [8.59] years; 97.6% male; 52.2% married). The mean (SD) number of days not at home within 180 days was 21.7 (34.5). Of the total cohort, 4.5% never returned home in the 180 days after their ED visit, while 18.2% had all subsequent days at home. ED admission (vs discharge) disposition was the factor associated with the largest increase in days not at home (rate ratio [RR], 3.18; 95% CI, 3.08-3.29). Patient factors associated with more days not at home included very high frailty (RR, 1.27; 95% CI, 1.21-1.33), unhoused status (RR, 1.50; 95% CI, 1.39-1.63), unmarried status (never married: RR, 1.24 [95% CI, 1.16-1.32]; divorced, separated, or widowed: RR, 1.24 [95% CI, 1.20-1.28]), and depression (RR, 1.13; 95% CI, 1.09-1.17). Conclusions and Relevance: The findings of this cohort study suggest that home time offers a patient-centered measure of post-ED outcomes for individuals with dementia. Future work should refine its application, particularly regarding the ED disposition decision, to better evaluate the long-term impact of ED care decisions.

Indexed as

DementiaEmergency Room VisitsEmergency Service, HospitalVeteransAgedAged, 80 and overFemaleHumansMaleRetrospective StudiesTime FactorsUnited StatesUnited States Department of Veterans Affairs

Identifiers

PMID41632170
PMCPMC12750257

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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.