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Assessment of depression, delirium and dementia in elderly patients who present to the Acute Medical Unit: a study of age-specific prevalence

Sláintecare is Ireland’s transformative strategic plan to build a world-class health service for the Irish people. It’s drivers include changing health needs, a growing and aging population, increasing health service usage and expectations of care. The Sláintecare implementation strategy highlights population health based planning, expansion of community based care, integration with the hospital sector and enablement via data driven quality improvement, research and innovation.
Systems of community emergency & unscheduled care bridge community and hospital care and are crucial to the implementation of Sláintecare. This health systems domain has however, limited current research activity and capacity. Ireland does possess a unique strength, having 5 years of national level clinical and health systems data via the Out-of- Hospital Cardiac Arrest Registry (OHCAR).
Out-of-Hospital cardiac arrest (OHCA) is one of the leading worldwide causes of premature mortality. It affects more than 2,500 people in Ireland annually. Survival at 7% is less than many other developed health systems. OHCA is a sentinel condition in community emergency & unscheduled care. Like other emergency conditions, favorable outcome depends on a time-critical, integrated health systems approach conceptualized as ‘the chain of survival’. By studying systems response to OHCA we can understand and improve the care of many similar time critical emergency conditions.
This project will evaluate and evolve OHCA care and outcome in Ireland. We will link registry data with other population and health systems datasets, interrogate to explore current gaps in performance, outcome and understanding based on the extensive international OHCA literature. We will utalise this data to design and model interventions to improve outcomes. Our process will link important existing datasets, build capacity in community emergency & unscheduled care research and act as the impetus for further research in this field. It is envisaged that feasibility studies and then definitive intervention trials will follow.