Logo image
Back
Emergency department utilization patterns among older adults
Journal article   Open access   Peer reviewed

Emergency department utilization patterns among older adults

Fredric D Wolinsky, Li Liu, Thomas R Miller, Hyonggin An, John F Geweke, Brian Kaskie, Kara B Wright, Elizabeth A Chrischilles, Claire E Pavlik, Elizabeth A Cook, …
The journals of gerontology. Series A, Biological sciences and medical sciences, Vol.63(2), pp.204-209
02/2008
DOI: 10.1093/gerona/63.2.204
PMCID: PMC2923576
PMID: 18314459
url
https://doi.org/10.1093/gerona/63.2.204View
Published (Version of record) Open Access

Abstract

We identified 4-year (2 years before and 2 years after the index [baseline] interview) ED use patterns in older adults and the factors associated with them. A secondary analysis of baseline interview data from the nationally representative Survey on Assets and Health Dynamics Among the Oldest Old linked to Medicare claims data. Participants were 4310 self-respondents 70 years old or older. Current Procedural Terminology (CPT) codes 99281 and 99282 identified low-intensity use, and CPT codes 99283-99285 identified high-intensity use. Exploratory factor analysis and multivariable multinomial logistic regression were used. The majority (56.6%) of participants had no ED visits during the 4-year period. Just 5.7% had only low-intensity ED use patterns, whereas 28.9% used the ED only for high-intensity visits, and 8.7% had a mixture of low-intensity and high-intensity use. Participants with lower immediate word recall scores and those who did not live in major metropolitan areas were more likely to be low-intensity-only ED users. Older individuals, those who did not live in rural counties, had greater morbidity and functional status burdens, and lower immediate word recall scores were more likely to be high-intensity-only ED users. Participants who were older, did not live in major cities, had lower education levels, had greater morbidity and functional status burdens, and lower immediate word recall scores were more likely to have mixed ED use patterns. Nearly half of these older adults used the ED at least once over a 4-year period, with a mean annual ED use percentage of 18.4. Few, however, used the ED only for visits that may have been avoidable. This finding suggests that triaging Medicare patients would not decrease ED overcrowding, although continued surveillance is necessary to detect potential changes in ED use patterns among older adults.
 United States Medicare Humans Risk Factors Female Logistic Models Male Aged Factor Analysis, Statistical Emergency Service, Hospital - statistics & numerical data

Details

Metrics

28 Record Views
38 Times Cited - Web of Science
Logo image