Self-reported health and life satisfaction in older emergency department patients: sociodemographic, disease-related and care-specific associated factors

Abstract

Background 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. 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. Methods Study 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. Results The 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. Conclusions SRH 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 registration EMANet 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).

Trait Anxiety and Health Attitude, Risk Factor Awareness, and Prevention of Cardiovascular Disease: A Study among the 25–44-Year-Old of Novosibirsk

“…Studies show that a more comprehensive understanding of health [39] includes not only the absence of health problems but also other possible determinants related to physical fitness and general well-being [40]. This is consistent with the WHO definition of health, which refers not only to the absence of disease or disability, but also to a state of complete physical, mental, and social well-being [41].…”

Primary and secondary data in emergency medicine health services research – a comparative analysis in a regional research network on multimorbid patients

“…Of all eligible patients, 56.3% in EMAAGE, 45.7% in EMACROSS and 45.4% in EMASPOT gave consent to participate in the respective studies. Reasons for non-participation of eligible patients were described elsewhere as a summary for all three study populations [ 24 ]. Gender and age – the only available categories for comparison in non-responders and participants – showed slight differences.…”

“…Inclusion into the primary data sample and extraction of secondary data was performed for patients in participating study EDs with at least one of the respective leading symptoms and diagnoses (see Additional Table 2 ) [ 24 ]. Model diseases and respective diagnoses were initially chosen from a publication on ambulatory care sensitive conditions (ACSC) in the German healthcare setting and adapted to the need of patient recruitment in the ED so that symptom diagnose codes were included [ 25 ].…”

Moderating effects of psychological factors and frequency of experiences in the emergency department: The role of perceived quality of healthcare

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