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Project Details - Ended
- Grant Number:R01 HS018420
- Funding Mechanism:
- AHRQ Funded Amount:$2,485,013
- Principal Investigator:
- Organization:
- Location:
- Project Dates:8/1/2010 to 5/31/2016
Project Categories
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Summary:
Increasing numbers of elderly and disabled persons are presenting to Emergency Departments (EDs) and require an assessment of their disabilities for treatment and proper referral. ED physicians are often challenged because these patients do not require acute care or hospitalization yet their failure to thrive in the community brings them repeatedly to the ED where their needs are often not met. This study aims to improve health outcomes of persons presenting to EDs by developing and validating a new disability diagnostic tool which will allow ED physicians to connect these patients to better health care referrals, proper long term care services, and other non-ED health care providers.
To improve health patient oriented outcomes in EDs, the project team is creating a tool, the Rasch Disability Diagnostic Tool (RDDT), and comparing it to the existing Measure of Disability (MOD). The retrospective phase of the study, tracking Yale-New Haven Hospital ED visits, treatments, and health outcomes, will use the RDDT to score disability indicators. The tool will be validated and a subset of the Rasch scale will be used as a brief measure for an ED randomized clinical trial. Prospectively, 600 patients will be recruited over the course of the study, randomized to either the RDDT (test arm) or MOD (control arm) and followed for two months. Disability assessments will be linked to patient oriented outcomes, such as health care service utilization and mortality.
This study will compare diagnoses to determine impact on patient outcomes and costs. The number of preventable ED visits and hospitalizations will be estimated to provide a cost benefit for adopting the RDDT in EDs. An additional exploratory aim of the study will assess work flow time and cost savings, efficiency, and usability for use of the RDDT in the ED. The potential impact of this research is that a better disability diagnostic tool will lead to lower mortality, a reduction in unnecessary costs, preventable ED visits and hospitalizations, and a better quality of life for patients presenting to EDs.
