Abstract
BackgroundSelf-reported health (SRH) and life satisfaction (LS) are patient-reported outcomes (PROs) that independently predict mortality and morbidity in older adults. Emergency department (ED) visits due to serious health problems or accidents might pose critical life events for patients. This study aimed (a) to characterize older patients’ SRH and LS during the distinct event of an ED stay, and (b) to analyze concomitant associations of PROs with ED patients’ sociodemographic, disease-specific and care-related variables.MethodsStudy personnel recruited mostly older ED patients from three disease groups during a two-year period (2017–2019) in eight EDs in central Berlin, Germany, in the context of the health services research network EMANet. Cross-sectional data from the baseline patient survey and associated secondary data from hospital information systems were analyzed. Multilevel linear regression models with random intercept were applied to assess concomitant associations with SRH (scale: 0 (worst) to 100 (best)) and LS (scale: 0 (not at all satisfied) to 10 (completely satisfied)) as outcomes, including sensitivity analyses.ResultsThe final sample comprised N = 1435 participants. Mean age was 65.18 (SD: 16.72) and 50.9% were male. Mean ratings of SRH were 50.10 (SD: 23.62) while mean LS scores amounted to 7.15 (SD: 2.50). Better SRH and higher LS were found in patients with cardiac symptoms (SRH: β = 4.35, p = .036; LS: β = 0.53, p = .006). Worse SRH and lower LS were associated with being in need of nursing care (SRH: β = − 7.52, p < .001; LS: β = − 0.59, p = .003) and being unemployed (SRH: β = − 8.54, p = .002; LS: β = − 1.27, p < .001). Sex, age, number of close social contacts, and hospital stays in the previous 6 months were additionally related to the outcomes. Sensitivity analyses largely supported results of the main sample.ConclusionsSRH and LS were associated with different sociodemographic and disease-related variables in older ED patients. Nursing care dependency and unemployment emerged as significant factors relating to both outcomes. Being able to identify especially vulnerable patients in the ED setting might facilitate patient-centered care and prevent negative health outcomes. However, further longitudinal research needs to analyze trajectories in both outcomes and suitable intervention possibilities in the ED setting.Trial registrationEMANet sub-studies were registered separately: German Clinical Trials Register (EMAAge: DRKS00014273, registration date: May 16, 2018; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00014273; EMACROSS: DRKS00011930, registration date: April 25, 2017; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00011930); ClinicalTrials.gov (EMASPOT: NCT03188861, registration date: June 16, 2017; https://clinicaltrials.gov/ct2/show/NCT03188861?term=NCT03188861&draw=2&rank=1).
Highlights
Self-reported health (SRH) and life satisfaction (LS) are patient-reported outcomes (PROs) that independently predict mortality and morbidity in older adults
Following inclusion and exclusion criteria, 2474 patients (45.0%) were excluded in the screening process with the main reasons for exclusion being inappropriate age (n = 1064) and inappropriate Emergency department (ED) diagnosis (n = 466). In this first step, excluded patients were counted as neutral non-responders since their ineligibility for study participation according to inclusion criteria of the three sub-studies did not affect the final size of the eligible study population
Main reasons for non-participation in the second step were researchpractical reasons and ED processes which prevented the approach of eligible patients (n = 739), e.g., missing
Summary
Self-reported health (SRH) and life satisfaction (LS) are patient-reported outcomes (PROs) that independently predict mortality and morbidity in older adults. Emergency department (ED) visits due to serious health problems or accidents might pose critical life events for patients. Emergency departments (EDs) in most Western countries face an increase in presentations by older persons with complex health care needs, e.g., multimorbid patients and those with unmet psychosocial needs in combination with somatic complaints [1, 2]. Serious health problems or accidents might pose critical life events for patients with potentially considerable implications for their psychological and physical well-being during hospitalization and after discharge [5,6,7]. Most health care services with their ‘silo’ structures are not designed for the delivery of comprehensive care which considers all of the patients’ needs in one setting [8,9,10]. Initiatives at addressing a variety of patients’ health and psychosocial needs in the health care setting exist (e.g. [11]), crowded ED environments and lack of respective clinician training in identifying and handling patients with complex needs further impedes adequate responses [12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
