Abstract
Background
Unscheduled emergency department (ED) presentation by patients with diabetes has seldom
been examined. This study aimed to determine the frequency and associated characteristics
of presentations in this population.
Methods
Using a prospective cross-sectional design, data were collected from patients with
diabetes presenting and/or admitted to a tertiary metropolitan hospital in New South
Wales, Australia (December 2016-September 2017). A screening interview including brief
measures of cognitive and executive function, and clinical details from healthcare
records were utilised; details around unscheduled presentations within 90 days were
extracted. Independent associations with ED presentation were determined.
Results
Unscheduled ED presentations were common; 35.4% had at least one within 90 days, and
for 20.1% this occurred within 28 days. The screening tool contributed little towards
identifying risk of unscheduled presentation. Those attending any community or outpatient
follow-up appointment within the first 28 (OR 0.42, 95% CI 0.23–0.76; p = 0.004) or
90 days (OR 0.25; 0.13–0.47; p < 0.001) from the index presentation were less likely
to present within that same period.
Conclusions
Findings indicated the magnitude of unscheduled ED presentation, care complexity and
the value of targeted and timely follow-up. Alternative service support may help maintain
and improve diabetes self-management and will require effectiveness and cost-effectiveness
evaluation.
Keywords
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Article info
Publication history
Published online: December 16, 2022
Accepted:
December 7,
2022
Received in revised form:
December 6,
2022
Received:
April 29,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.
