DIVERT Scale Predicts Risk of Emergency Department Use in Older Patients

Canadian researchers have developed a scale to assess the risk of future emergency department use among older adults who live at home. Study results confirmed the validity of the Detection of Indicators and Vulnerabilities for Emergency Room Trips (DIVERT) Scale for predicting emergency department use in the population. “It may be suitable for preemptively and systematically risk-stratifying individuals or groups for additional assessment, case management, and preventative interventions,” the researchers reported. “It may also be suitable for the stratification and adjustment of performance metrics.”

To develop and validate the tool, researchers retrospectively analyzed data from home care assessments of 361,942 older adults in Canada and linked them with emergency department use.  Approximately 41% of participants had at least one emergency department visit within 6 months of their assessment. Previous use of the emergency department, cardiorespiratory symptoms, cardiac conditions, and specific geriatric syndromes were predictors of future emergency department use, researchers found. The six-level DIVERT Scale provided adequate risk differentiation for case finding, researchers reported, and showed consistent performance across geographic and patient groups. The researchers published the study in the April 2015 Journal of the American Geriatrics Society (https://onlinelibrary.wiley.com/doi/10.1111/jgs.13336/abstract).