Validating the DIVERT scales, CARS, and EARLI for predicting emergency department visits in home health care in Japan: A retrospective cohort study
2025

Validating Risk Scales for Emergency Department Visits in Home Health Care Patients in Japan

Sample size: 224 publication Evidence: moderate

Author Information

Author(s): Ono Takao, Watase Hiroko, Ishihara Takuma, Watase Taketo, Kang Kiho, Iwata Mitsunaga

Primary Institution: Fujita Health University School of Medicine

Hypothesis

Can the addition of patient age and advance care planning improve the predictive accuracy of risk assessment scales for emergency department visits among home health care patients in Japan?

Conclusion

The study validated the DIVERT scales, CARS, and EARLI for predicting emergency department visits among Japanese home health care patients, showing that adding age and advance care planning improves their predictive accuracy.

Supporting Evidence

  • 40 patients (17.8%) had at least one ED visit during the study period.
  • The AUC for the DIVERT scale was 0.62, indicating moderate predictive accuracy.
  • Adding age and advance care planning improved the AUC for all three scales.
  • Patients with at least one ED visit were more likely to have received advance care planning.

Takeaway

This study looked at how well certain scales can predict if home health care patients will need to go to the emergency room, and found that including a patient's age and planning for their care can make these predictions better.

Methodology

A single-center retrospective cohort study was conducted to assess the validity of the DIVERT scale, CARS, and EARLI in predicting emergency department visits among home health care patients.

Potential Biases

There is a risk of selection bias and confounding factors affecting the generalizability of the findings.

Limitations

The study may have selection bias due to being conducted at a single center and potential confounding factors that were not fully controlled.

Participant Demographics

The mean age of participants was 79.2 years, with a majority being older adults receiving home health care.

Statistical Information

P-Value

p<0.05

Confidence Interval

95% CI: 0.52–0.72

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1002/jgf2.738

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