For a study, the researchers sought to determine predictors of emergency department (ED) used by adult hemodialysis (HD) patients, as well as treatments to reduce ED use by HD patients. Investigators looked for randomized controlled trials, and observational research published till April 2020 in Ovid MEDLINE, Ovid Embase, and the Cochrane Library. Outlines that looked into determinants of ED use and interventions to reduce ED use in HD patients were included. Using Excel software, they retrieved data about the research design, demographic, and outcomes of ED utilization from 38 outcomes. To group articles that examined related themes, they used narrative synthesis. About 1,060 titles and abstracts were evaluated, 98 were chosen for full-text review. In all, 38 research met the criteria for inclusion and were subjected to data extraction. According to the Downs and Black tool, quality was excellent, with 11 outlines evaluated as good, 22 as fair, and 5 as poor.
Furthermore, 4 research evaluated interventions in which ED utilization was determined, while 34 outlines described predictors of ED utilization. In the fundamental concepts of access to care, comorbid condition load, and innovative health care models, the study team’s narrative synthesis yielded 8 topic subgroups. Increased ED utilization was linked to a lack of access to care and a large comorbid disease load. There were no ED-based interventions shown to reduce ED use. Still, improvements in health care systems, such as the development of End-Stage Renal Disease Seamless Care Organizations and increased involvement of palliative care services, have been linked to better outcomes. A meta-analysis was not possible due to clinical heterogeneity and variability in the included research. The high ED utilization of HD patients was due to various factors. More investigation was needed to better understand and anticipate ED usage in this vulnerable group, which would have aided in developing treatments to prevent unnecessary ED visits.
Source-www.sciencedirect.com/science/article/pii/S2590059521002491
