Caregiver burden and early readmission after ED discharge: an interrupted time series

One-third of all patients consulting emergency departments (ED) are seniors and an additional one-third of seniors admitted to the ED report care coordination problems, chief among them are gaps in hospital discharge planning and long waiting lists to receive home care services. It remains unclear whether (1) burden of care among caregivers of elderly patients can account for varying levels of success in reducing ED visits, readmission rates, and length of stay in the hospital among this elderly population, and (2) how the COVID-19 pandemic may have moderated the relation.With a sample of approximately 4000 patients from the LEARNING WISDOM context-adapted CISSS-CA ACE (Centre intégré de santé et de services sociaux de Chaudière-Appalaches Acute Care for Elders) program we will explore whether burden of care reported by caregivers can predict admission to and early revisits to the ED among elderly patients with many different health backgrounds and complaints.We will leverage Learning Wisdoms interrupted time series to assess the CISSS-CA-ACE intervention's effects on early revisits to the ED as moderated by caregiver burden. As the CISSS-CA-ACE program was likely significantly disrupted by the COVID-19 pandemic, we also intend to conduct an additional interrupted time series over each wave of the COVID-19 pandemic.We suspect that higher indices of burden of care in the later waves of the pandemic translate to especially large rates of early readmission among elderly patients. The results from this inquiry may contribute to our understanding of individual differences in strain and burden among older adults and their caregivers are related to real-world health outcomes.