Simple Segmentation Tool to Understand Elderly Health Status and Needs

Background: The delivery of targeted, patient-centered care for a population with heterogeneous healthcare needs while moderating costs is a key challenge in healthcare. Segmentation of patient populations based on clinically distinguishing features and social healthcare needs is currently a promising method for informing the organization of healthcare supply to these needs. Aims: In this prospective cohort study, the investigators aim to assess the Simple Segmenting Tool (SST) as a method of patient population segmentation in terms of its inter-rater reliability, as well as convergent and predictive validity. We will also revise the tool based on feedback from the validity studies should the need arises. Hypothesis: The investigators hypothesize that the SST is able to exhibit good inter-rater reliability, convergent validity and predictive validity for adverse events. Methodology: Non-critical patients aged 55 and above presenting to the Emergency Department will be screened with the SST. Raters will be paired in order to assess inter-rater reliability. To test convergent validity, the LACE, SF-12, and Clinical Frailty Scale (CFS) will also be used. Finally, predictive validity will be assessed by evaluating adverse event rates of patients in each SST category. Adverse events include all-cause mortality, length of hospital stay, emergency department visit and unplanned hospital readmission. Significance to Health Services Delivery: This study will provide evidence supporting the use of a standardized tool for evaluating the medical and social needs of patients at various sites of care. Following which, tailored packages of healthcare services can then be delivered in order to meet these needs.