Results of a 2-round modified Delphi exercise to establish which patient characteristics are important to consider when classifying whether an emergency department visit was primary care–like and potentially redirectable to subacute care centres by paramedics
Characteristic | Round 1, no. (%)* | Round 2, no. (%)*† | Consensus | Specification of parameters from expert committee‡ | ||
---|---|---|---|---|---|---|
Yes | No | Yes | No | |||
Age, yr | 13 (81) | 3 (19) | – | – | Useful | Lowest age: 18 (n = 13)¶ Highest age: 50 (n = 1), 55 (n = 1), 65 (n = 1), 70 (n = 5),** 75 (n = 3), no upper limit (n = 2) |
Sex | 0 (0) | 16 (100) | – | – | Not useful | Not useful to include and/or specify |
Triage acuity, CTAS | 16 (100) | 0 (0) | – | – | Useful | Lowest acuity: CTAS level 5 (n = 16)¶ Highest acuity: CTAS level 4 (n = 12),** CTAS level 3 (n = 6) |
Main diagnostic category, ICD-10§ | 9 (56) | 7 (44) | 10 (67) | 5 (33) | No consensus | Consensus was not reached among the Delphi committee |
Comorbidities | 4 (25) | 12 (75) | – | – | Not useful | Not useful to include and/or specify |
Specialist consult performed in ED | 15 (94) | 1 (6) | – | – | Useful | Include only visits that did not receive a specialist consult in the ED (n = 15) |
Outcome of ED visit | 13 (81) | 3 (19) | – | – | Useful | Discharged from ED (n = 13) Admitted to hospital (n = 1) Transfer to another acute care facility directly from ED (n = 1) Left after triage, no medical assessment (n = 6) |
Time from triage to ED outcome | 2 (12) | 14 (88) | – | – | Not useful | Not useful to include and/or specify |
Return to ED within ≤ 30 d | 7 (44) | 9 (56) | 3 (20) | 12 (80) | Not useful | Not useful to include and/or specify |
Note: CTAS = Canadian Triage and Acuity Scale, ED = emergency department, ICD-10 = International Statistical Classification of Diseases and Related Health Problems, 10th Revision.
↵* Consensus set at 75% agreement of all experts.
↵† Fifteen of the 16 experts participated in Round 2.
↵‡ Only experts who answered “Yes” to the consensus question were included to specify parameters.
↵§ Category did not receive consensus after Round 2.
↵¶ Indicates the lower bound of a characteristic parameter.
↵** Indicates the upper bound of a characteristic parameter.