TY - JOUR
T1 - Predictors of admission after emergency department discharge in older adults
AU - Gabayan, Gelareh Z.
AU - Sarkisian, Catherine A.
AU - Liang, Li Jung
AU - Sun, Benjamin C.
N1 - Publisher Copyright:
© 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - 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.
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.
KW - Emergency department
KW - Medicare
KW - Outcomes
UR - http://www.scopus.com/inward/record.url?scp=84925235379&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84925235379&partnerID=8YFLogxK
U2 - 10.1111/jgs.13185
DO - 10.1111/jgs.13185
M3 - Article
C2 - 25537073
AN - SCOPUS:84925235379
SN - 0002-8614
VL - 63
SP - 39
EP - 45
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 1
ER -