J Korean Acad Fundam Nurs.  2025 May;32(2):243-252. 10.7739/jkafn.2025.32.2.243.

Association between Health Information Exchange and Health Outcomes in Older Patients Transferred from Long-term Care to the Emergency Department: A Retrospective Review

• Kim HJ
• Choi S

• KMID: 2568293
• DOI: http://doi.org/10.7739/jkafn.2025.32.2.243

Abstract

Purpose
This study investigated the association between the level of health information exchange (HIE) and health outcomes in older patients transferred from long-term care settings to the emergency department (ED). It focused on the relationship between HIE and ED length of stay, hospital length of stay, and unexpected ED revisits.
Methods
A retrospective analysis was conducted of medical records for 452 cases involving 362 patients aged ≥65 years, transferred to the ED of a university hospital from July 2017 to June 2018.
Results
The mean number of exchanged health information items was 1.33±2.45. Long-term care hospitals exchanged significantly more information than long-term care facilities (Z=-13.81, p<.001). A significant negative correlation was observed between the level of information exchange and ED length of stay (p=-.160, p=.001), suggesting that more extensive HIE may reduce the time older patients spend in the ED. However, no significant correlations were found between HIE and hospital length of stay or unexpected ED revisits.
Conclusion
These results highlight the urgent need to improve HIE practices. Further studies are needed to investigate other factors that may influence long-term health outcomes and the effectiveness of health systems in managing older patients transferred to long-term care settings.

Keyword

Aged; Emergency service; hospital; Health information exchange; Long-term care; Patient transfer