Emergency department utilisation among older people with acute and/or chronic conditions: A multi-centre retrospective study

Fry, Margaret; Fitzpatrick, Lesley; Considine, Julie; Shaban, Ramon Z.; Curtis, Kate

doi:10.1016/j.ienj.2016.09.004

Cited by 18 publications

(14 citation statements)

References 31 publications

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“…At KAUH, ED visits by geriatric patients constitute 19.14% of all ED visits, within the wide range of 12.4%-28.4% found in other international and national studies [7][8] . Moreover, the average age of 71.25 years compares favorably with that found in other studies, which was 79.2 years in Australia [15] , 74.9 years in Turkey [16] , and 72.8 years in Singapore [7] . In other studies, triage prioritization showed that 16% of ED visits were emergencies, considerably less than our fi nding (36%) [4,15] .…”

Section: Discussionsupporting

confidence: 74%

“…We found that 47% of the geriatric patients were discharged, lower than what we found in other studies (63 to 89%) [4,16] . We found a mortality rate of 2%, but the greatest rate reported by other studies was only 0.9% [4,7,15,16] .…”

Section: Discussioncontrasting

confidence: 58%

“…We found that only 0.9% arrived by ambulance. Th is fi gure is 58% in Australia [15] and 32.7% in Singapore [7] . It is not clear why geriatric patients in Saudi Arabia do not utilize ambulances for visits to the ED.…”

Section: Discussionmentioning

confidence: 99%

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Geriatric Visits to the Emergency Department at an Academic Tertiary Care Center in Jeddah, Saudi Arabia

et al. 2017

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Objectives: Geriatric patients aged more than 60 years are a vulnerable group of patients needing special care in the emergency department. This study aims to determine the prevalence of geriatric patients visiting the emergency department and explore the various aspects of those visits. Methods: A retrospective chart review of all emergency department visits from August 2016 to July 2017 was performed at King Abdulaziz University Hospital in Jeddah, Saudi Arabia. Results: Of 34,127 emergency department visits by adults, 6,533 (19.14%) were made by geriatric patients (age range, 60-115 years; average, 71.25 years), representing about 45 nationalities (48.62% were Saudi). Triage priority using the “Canadian Triage and Acuity Scale” showed that 36.08% of the visits were emergencies, 49.35% were urgent, and 14.57% were non-urgent. Most (40.47%) of the visits were made during the morning, almost double the number made at night (23.30%). Geriatric patients presenting with a single complaint represented 62.47% of these visits, those presenting with two complaints represented 31.01%, and those presenting three or more complaints, 6.52%. The most common complaints were dyspnea (25.28%), chest pain (13.16%), and abdominal pain (10.82%). In the final diagnoses, diseases of circulatory system were most frequent (15.20%). The admission rate was 28.38%, and the mortality rate was 1.94%. Conclusion: Geriatric patients visiting the emergency department represent one-fi ft h of all emergency department visits by adults. They commonly present with complex medical conditions, making the approach to their diagnoses more challenging. Therefore, we recommend paying greater attention using multidisciplinary services and follow up.

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Section: Discussionsupporting

confidence: 74%

Section: Discussioncontrasting

confidence: 58%

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Geriatric Visits to the Emergency Department at an Academic Tertiary Care Center in Jeddah, Saudi Arabia

et al. 2017

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“…The Stable group had ED visits that did not result in hospitalizations, which could indicate that they were using the ED more proactively, or for subacute care. A study of ED utilization found that older adults with acute conditions were more likely to be admitted to the hospital than those who were presenting with a chronic condition [51]. The Confident group had more hospitalizations than ED visits, which could indicate that they were not seeking out emergent care and were admitted through clinic visits.…”

Section: Discussionmentioning

confidence: 99%

Illness Representation and Self-Care Ability in Older Adults with Chronic Disease

et al. 2018

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Chronic illness affects >50% of adults in the United States and accounts for >80% of healthcare spending. The purpose of this study was to determine whether beliefs about one’s chronic disease (illness representation) are associated with self-care activation, emergency department (ED) visits, or hospitalizations. Using a cross-sectional design, we recruited older adults with heart failure, chronic obstructive pulmonary disease (COPD), and chronic kidney disease. The Revised Illness Perception Questionnaire (IPQ-R) measured perceptions about disease. The Patient Activation Measure measured self-care activation. ED visits and hospitalizations were measured by self-report. IPQ-R scores were analyzed using latent profile analysis to identify subgroups. Participants included 187 adults (mean age 65 years, 54% female, 74% Black). We found three subgroups (stable, overwhelmed, and confident). Groups did not differ demographically or by disease. The stable group (few consequences, non-fluctuating pattern) had the fewest hospitalizations. The overwhelmed group (many consequences, fluctuating pattern, high negative emotion) had high hospitalizations and low self-care ability. The confident group (high disease control, well-understood) had the highest self-care ability, but also high hospitalizations. ED visits did not differ by group. We found three subgroups that differ in their illness representation and health outcomes. Findings suggest that assessing patients’ illness representations may have important implications for subgroup-specific interventions.

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“…The Emergency Department (ED) is the gateway through which the majority of patients are admitted into the hospital setting (Fry et al, 2018). Currently there are many challenges for EDs including increasing patient attendances, an ageing population with more complex health needs, and a depleted workforce with a widespread shortage of emergency medical trainees, senior emergency doctors, and nurses at all levels (Hunt 2016, Cowling et al 2014.…”

Section: Introductionmentioning

confidence: 99%

Does the @home team reduce local Emergency Department attendances? The experience of one London service

Pickstone

Lee

2019

International Emergency Nursing

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Emergency department utilisation among older people with acute and/or chronic conditions: A multi-centre retrospective study

Cited by 18 publications

References 31 publications

Geriatric Visits to the Emergency Department at an Academic Tertiary Care Center in Jeddah, Saudi Arabia

Geriatric Visits to the Emergency Department at an Academic Tertiary Care Center in Jeddah, Saudi Arabia

Illness Representation and Self-Care Ability in Older Adults with Chronic Disease

Does the @home team reduce local Emergency Department attendances? The experience of one London service

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