Implementation of a novel computer assisted telephone follow-up model for older patients after emergency department discharge in an Asian population

TL;DR

A new computer-assisted telephone follow-up model for older patients after emergency department discharge was tested in Taiwan, showing lower medical costs and higher satisfaction, though with a higher short-term hospitalization risk.

Contribution

A novel computer-assisted telephone follow-up model was implemented and evaluated for older Asian patients after emergency department discharge.

Findings

The TFU cohort had lower total medical expenditure within one month compared to the non-TFU cohort.

The TFU cohort showed higher patient satisfaction scores.

The TFU cohort had a higher risk of hospitalization within one month compared to the non-TFU cohort.

Abstract

While the impact of telephone follow-up (TFU) for older emergency department (ED) patients is controversial, its effects on the Asian population remain uncertain. In this study, we evaluated the effectiveness of a novel computer assisted TFU model specifically for this demographic.

At a Taiwanese tertiary medical center, we developed a TFU protocol that included a referral and case management system within the ED hospital information system. We provided TFU to older discharged patients between April 1, 2021, and May 31, 2021. We compared this cohort with a non-TFU cohort of older ED patients and analyzed demographic characteristics and post-ED discharge outcomes.

The TFU model was successfully implemented, with 395 patients receiving TFU and 191 without TFU. TFU patients (median age: 76 years, male proportion: 48.9%) differed from non-TFU patients (median age: 74 years, male proportion: 43.5%). Compared with the non-TFU cohort, the multivariate logistic regression analysis revealed that the TFU cohort had a lower total medical expenditure < 1 month (adjusted odds ratio [AOR]: 0.32; 95% CI: 0.21 − 0.47 for amounts exceeding 5,000 New Taiwan Dollars), and higher satisfaction (AOR: 2.80; 95% CI: 1.46 − 5.36 for scores > 3 on a five-point Likert Scale). However, the TFU cohort also had a higher risk of hospitalization < 1 month (AOR: 2.50; 95% CI: 1.31 − 4.77) compared to the non-TFU cohort.

Computer-assisted TFU appears promising. Further research involving a larger number of patients and validation in other hospitals is necessary to bolster the evidence and extend the findings to a broader context.

The online version contains supplementary material available at 10.1007/s40520-024-02796-6.

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