Predictors of admission after emergency department discharge in older adults

Gelareh Z. Gabayan, Catherine A. Sarkisian, Li Jung Liang, Benjamin Sun

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

OBJECTIVES: To identify predictors of hospital inpatient admission of older Medicare beneficiaries after discharge from the emergency department (ED). DESIGN: Retrospective cohort study. SETTING: Nonfederal California hospitals (n = 284). PARTICIPANTS: Visits of Medicare beneficiaries aged 65 and older discharged from California EDs in 2007 (n = 505,315). MEASUREMENTS: Using the California Office of Statewide Health Planning and Development files, predictors of hospital inpatient admission within 7 days of ED discharge in older adults (≥65) with Medicare were evaluated. RESULTS: Hospital inpatient admissions within 7 days of ED discharge occurred in 23,340 (4.6%) visits and were associated with older age (70-74: adjusted odds ratio (AOR) = 1.12, 95% confidence interval (CI) = 1.07-1.17; 75-79: AOR = 1.18, 95% CI = 1.13-1.23; ≥80: AOR = 1.4, 95% CI = 1.35-1.46), skilled nursing facility use (AOR = 1.82, 95% CI = 1.72-1.94), leaving the ED against medical advice (AOR = 1.82, 95% CI = 1.67-1.98), and the following diagnoses with the highest odds of admission: end-stage renal disease (AOR = 3.83, 95% CI = 2.42-6.08), chronic renal disease (AOR = 3.19, 95% CI = 2.26-4.49), and congestive heart failure (AOR = 3.01, 95% CI = 2.59-3.50). CONCLUSION: Five percent of older Medicare beneficiaries have a hospital inpatient admission after discharge from the ED. Chronic conditions such as renal disease and heart failure were associated with the greatest odds of admission.

Original languageEnglish (US)
Pages (from-to)39-45
Number of pages7
JournalJournal of the American Geriatrics Society
Volume63
Issue number1
DOIs
StatePublished - Jan 1 2015

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Hospital Emergency Service
Odds Ratio
Confidence Intervals
Medicare
Inpatients
Heart Failure
Skilled Nursing Facilities
Health Planning
Chronic Renal Insufficiency
Chronic Kidney Failure
Renal Insufficiency
Cohort Studies
Retrospective Studies

Keywords

  • Emergency department
  • Medicare
  • Outcomes

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Predictors of admission after emergency department discharge in older adults. / Gabayan, Gelareh Z.; Sarkisian, Catherine A.; Liang, Li Jung; Sun, Benjamin.

In: Journal of the American Geriatrics Society, Vol. 63, No. 1, 01.01.2015, p. 39-45.

Research output: Contribution to journalArticle

Gabayan, Gelareh Z. ; Sarkisian, Catherine A. ; Liang, Li Jung ; Sun, Benjamin. / Predictors of admission after emergency department discharge in older adults. In: Journal of the American Geriatrics Society. 2015 ; Vol. 63, No. 1. pp. 39-45.
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abstract = "OBJECTIVES: To identify predictors of hospital inpatient admission of older Medicare beneficiaries after discharge from the emergency department (ED). DESIGN: Retrospective cohort study. SETTING: Nonfederal California hospitals (n = 284). PARTICIPANTS: Visits of Medicare beneficiaries aged 65 and older discharged from California EDs in 2007 (n = 505,315). MEASUREMENTS: Using the California Office of Statewide Health Planning and Development files, predictors of hospital inpatient admission within 7 days of ED discharge in older adults (≥65) with Medicare were evaluated. RESULTS: Hospital inpatient admissions within 7 days of ED discharge occurred in 23,340 (4.6{\%}) visits and were associated with older age (70-74: adjusted odds ratio (AOR) = 1.12, 95{\%} confidence interval (CI) = 1.07-1.17; 75-79: AOR = 1.18, 95{\%} CI = 1.13-1.23; ≥80: AOR = 1.4, 95{\%} CI = 1.35-1.46), skilled nursing facility use (AOR = 1.82, 95{\%} CI = 1.72-1.94), leaving the ED against medical advice (AOR = 1.82, 95{\%} CI = 1.67-1.98), and the following diagnoses with the highest odds of admission: end-stage renal disease (AOR = 3.83, 95{\%} CI = 2.42-6.08), chronic renal disease (AOR = 3.19, 95{\%} CI = 2.26-4.49), and congestive heart failure (AOR = 3.01, 95{\%} CI = 2.59-3.50). CONCLUSION: Five percent of older Medicare beneficiaries have a hospital inpatient admission after discharge from the ED. Chronic conditions such as renal disease and heart failure were associated with the greatest odds of admission.",
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AB - OBJECTIVES: To identify predictors of hospital inpatient admission of older Medicare beneficiaries after discharge from the emergency department (ED). DESIGN: Retrospective cohort study. SETTING: Nonfederal California hospitals (n = 284). PARTICIPANTS: Visits of Medicare beneficiaries aged 65 and older discharged from California EDs in 2007 (n = 505,315). MEASUREMENTS: Using the California Office of Statewide Health Planning and Development files, predictors of hospital inpatient admission within 7 days of ED discharge in older adults (≥65) with Medicare were evaluated. RESULTS: Hospital inpatient admissions within 7 days of ED discharge occurred in 23,340 (4.6%) visits and were associated with older age (70-74: adjusted odds ratio (AOR) = 1.12, 95% confidence interval (CI) = 1.07-1.17; 75-79: AOR = 1.18, 95% CI = 1.13-1.23; ≥80: AOR = 1.4, 95% CI = 1.35-1.46), skilled nursing facility use (AOR = 1.82, 95% CI = 1.72-1.94), leaving the ED against medical advice (AOR = 1.82, 95% CI = 1.67-1.98), and the following diagnoses with the highest odds of admission: end-stage renal disease (AOR = 3.83, 95% CI = 2.42-6.08), chronic renal disease (AOR = 3.19, 95% CI = 2.26-4.49), and congestive heart failure (AOR = 3.01, 95% CI = 2.59-3.50). CONCLUSION: Five percent of older Medicare beneficiaries have a hospital inpatient admission after discharge from the ED. Chronic conditions such as renal disease and heart failure were associated with the greatest odds of admission.

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