Table 1
Profile of the older (≥ 65 years old) patients presented to a regional NZ hospital Emergency Department (N=1376) showing percentage referred to the multidisciplinary team (MDT) within each group and the percentage of total referrals (n=175) along with the odds ratios of being referred for each group within each category.
| Category1 | Group | % (n) | % of total | % referred | Univariate Analyses3 | |
|---|---|---|---|---|---|---|
| Referrals (n) | to MDT2 | P value | Odds ratio (95% CI) | |||
| Gender | Female | 53.1 (730) | 64.6 (113) | 15.5 | 0.001 | 1.257 (1.112, 1.421) |
| Male | 46.9 (646) | 35.4 (62) | 9.6 | 0.729 (0.592, 0.897) | ||
| All European | Yes | 89.4 (1230) | 95.4 (167) | 13.6 | 0.005 | 1.078 (1.038, 1.120) |
| No | 10.6 (146) | 4.6 (8) | 5.5 | 0.398 (0.199, 0.797) | ||
| Māori | Yes | 8.5 (116) | 3.4 (6) | 5.2 | 0.011 | 0.374 (0.152, 0.814) |
| No | 91.6 (1260) | 96.6 (169) | 13.4 | 1.063 (1.028, 1.099) | ||
| Pacifica | Yes | 1.2 (17) | 0.0 (0) | 0.0 | 0.113 | . |
| No | 98.6 (1184) | 100.0 (175) | 12.9 | 1.014 (1.008, 1.021) | ||
| Other/missing | Yes | 0.9 (13) | 1.1 (2) | 15.4 | 0.772 | 1.248 (0.279, 5.583) |
| No | 99.1 (1363) | 98.9 (173) | 12.7 | 0.998 (0.981, 1.015) | ||
| Married/De-facto | Yes | 53.3 (733) | 33.7 (59) | 8.0 | <0.001 | 0.601 (0.485, 0.744) |
| No | 46.7 (643) | 66.3 (116) | 18.0 | 1.511 (1.335, 1.709) | ||
| 65–69 years | Yes | 24.2 (333) | 10.3 (18) | 5.4 | <0.001 | 0.392 (0.251, 0.614) |
| No | 75.8 (1043) | 89.7 (157) | 15.1 | 1.216 (1.145, 1.292) | ||
| 70–79 years | Yes | 42.4 (583) | 33.7 (59) | 10.1 | 0.013 | 0.773 (0.622, 0.960) |
| No | 57.6 (793) | 66.3 (116) | 14.6 | 1.176 (1.046, 1.322) | ||
| 80–89 years | Yes | 29.4 (405) | 46.9 (82) | 20.2 | <0.001 | 1.742 (1.451, 2.093) |
| No | 70.6 (971) | 53.1 (93) | 9.6 | 0.727 (0.630, 0.839) | ||
| 90 + years | Yes | 4.0 (55) | 9.1 (16) | 29.1 | <0.001 | 2.816 (1.608, 4.928) |
| No | 96.0 (1321) | 90.9 (159) | 12.0 | 0.936 (0.895, 0.985) | ||
| Previous LOS< 6 days | Yes | 31.7 (436) | 30.3 (53) | 12.2 | 0.670 | 0.950 (0.747, 1.207) |
| No | 68.3 (940) | 69.7 (122) | 13.0 | 1.024 (0.921, 1.137) | ||
| Previous LOS> 5 days | Yes | 22.2 (305) | 37.7 (66) | 21.6 | <0.001 | 1.895 (1.518, 2.365) |
| No | 77.8 (1071) | 62.3 (109) | 10.2 | 0.778 (0.691, 0.876) | ||
| COPD | Yes | 14.6 (201) | 21.7 (38) | 18.9 | 0.004 | 1.600 (1.167, 2.193) |
| No | 85.4 (1175) | 78.3 (137) | 11.7 | 0.906 (0.835, 0.982) | ||
| Cardiac conditions | Yes | 39.2 (540) | 43.4 (76) | 14.1 | 0.225 | 1.124 (0.936, 1.351) |
| No | 60.8 (836) | 56.6 (99) | 11.8 | 0.922 (0.804, 1.058) | ||
| Stroke | Yes | 10.1 (139) | 13.1 (23) | 16.5 | 0.153 | 1.361 (0.896, 2.068) |
| No | 89.9 (1237) | 86.9 (152) | 12.3 | 0.961 (0.905, 1.021) | ||
| Dementia | Yes | 3.1 (43) | 4.6 (8) | 18.6 | 0.239 | 1.569 (0.740, 3.326) |
| No | 96.9 (1333) | 95.4 (167) | 12.5 | 0.983 (0.950, 1.017) | ||
| Cancer | Yes | 17.2 (236) | 17.1 (30) | 12.7 | 0.998 | 0.999 (0.705, 1.416) |
| No | 82.8 (1140) | 82.9 (145) | 12.7 | 1.000 (0.931, 1.075) | ||
| Diabetes | Yes | 19.0 (261) | 14.3 (25) | 9.6 | 0.091 | 0.727 (0.497, 1.064) |
| No | 81.0 (1115) | 85.7 (150) | 13.5 | 1.067 (0.998, 1.140) | ||
[i] 1Gender and Ethnicity are not part of the Elders Risk Assessment Criteria. LOS = length of stay, COPD = Chronic Obstructive Pulmonary/Respiratory Disease.
2A P value <0.05 in the univariate analysis (Pearson’s Chi-square test or Fisher’s Exact Tests) indicates the percentage referrals to MDT for each group within the category is significantly different.
32X2 contingency tables of MDT referral (yes, no) and category (yes, no) were analyzed using a Pearson’s Chi-square test and used to calculate the odds ratios.
Figure 1
The percentage of multi-disciplinary team referrals recorded for each Elders Risk Assessment Index (solid line) with the linear trendline (dotted).
Table 2
Odds ratios of a multidisciplinary team (MDT) referral and their significance (P value) as determined by a forward and backward stepwise binary logistic regressions for those Elders Risk Assessment (ERA) Criteria in Table 1 that had a P<0.100 in the univariate analyses.
| Lower | Upper | |||
|---|---|---|---|---|
| Model: Index only | ||||
| Index | <0.001 | 1.085 | 1.060 | 1.112 |
| Model: Index with gender and ethnicity | ||||
| Index | <0.001 | 1.091 | 1.065 | 1.118 |
| Gender (female/male) | 0.001 | 1.805 | 1.287 | 2.532 |
| Ethnicity (reference: European) | 0.026 | |||
| Maori | 0.002 | 0.269 | 0.115 | 0.628 |
| Pacifica | 0.998 | 0.000 | 0.000 | – |
| Other | 0.862 | 1.149 | 0.237 | 5.571 |
| Model: Index components from univariate analyses with P<0.1 | ||||
| Married | 0.001 | 0.538 | 0.378 | 0.766 |
| LOS>5days | <0.001 | 2.104 | 1.476 | 3.001 |
| COPD | 0.020 | 1.638 | 1.080 | 2.484 |
| Diabetes | 0.027 | 0.589 | 0.369 | 0.941 |
| Age groups (reference: 65–70) | <0.001 | |||
| 90+ | <0.001 | 4.662 | 2.132 | 10.192 |
| 80 – 89 | <0.001 | 3.299 | 1.902 | 5.722 |
| 70 – 79 | 0.051 | 1.736 | 0.997 | 3.024 |
| Model: Index components from univariate analyses with P<0.1 with gender and ethnicity | ||||
| Married | 0.002 | 0.554 | 0.384 | 0.798 |
| LOS>5days | <0.001 | 2.162 | 1.512 | 3.092 |
| COPD | 0.005 | 1.842 | 1.203 | 2.821 |
| Diabetes | 0.047 | 0.618 | 0.385 | 0.993 |
| Age groups (reference: 65–70) | <0.001 | |||
| 90+ | 0.001 | 3.936 | 1.789 | 8.660 |
| 80 – 89 | <0.001 | 2.835 | 1.624 | 4.950 |
| 70 – 79 | 0.084 | 1.635 | 0.935 | 2.859 |
| Gender (female/male) | 0.024 | 1.505 | 1.056 | 2.143 |
| Ethnicity (reference: European) | 0.103 | |||
| Maori | 0.014 | 0.337 | 0.141 | 0.805 |
| Pacifica | 0.998 | 0.000 | 0.000 | – |
| Other | 0.688 | 1.388 | 0.281 | 6.861 |