Emergency hospital admissions for ill‐defined conditions amongst older people: a review of the literature

Abstract

Objective. To conduct a review of the literature on frequency and characteristics of emergency hospital admissions of older people for ill-defined conditions. Background. Emergency hospital admissions for ill-defined conditions are increasing for older people. Despite concern about this trend little is known about the frequency or characteristics of such admissions in emergency medical settings. Method. Relevant papers were identified by searching Medline, Cinahl, Web of Science and other databases. Papers that met inclusion criteria were selected. A descriptive analysis approach was taken. Results. Eighteen studies met the inclusion criteria for the review, all descriptive, survey or cohort studies. None directly investigated the patient group. Some relevant data were available, particularly in relation to frequency of admissions for ill-defined conditions. Conclusions. There is a paucity of research on the patient group, but the evidence available suggests the incidence of these admissions is high in emergency settings and in many countries. Future research on incidence in specific settings, appropriateness of admissions and patient characteristics is urgently required. Relevance to clinical practice. As the population ages increased numbers of older people will be admitted to hospital for ill-defined conditions. Nursing interventions may contribute to future management of these patients.

Features and outcomes of unplanned hospital admissions of older people due to ill-defined (R-coded) conditions: Retrospective analysis of hospital admissions data in England

“…This finding contrasts with estimates of up to 10% of all hospital admissions internationally [21] and 7% in England [11], but is consistent with higher rates in studies focused on urgent care settings [9,10,14]. If these are indeed avoidable admissions, the scale of the problem presented by ill-defined conditions in acute medical settings may have been underestimated.…”

The ‘unnecessary’ use of emergency departments by older people: findings from hospital data, hospital staff and older people

“…6,[8][9][10] These presentations are often classified as 'unnecessary' or 'avoidable'. 11,12 As EDs may not be designed to meet the needs of older people and may place the older person at risk of further adverse outcomes, 13,14 reducing unnecessary presentations may assist with the overcrowding problem experienced by EDs and lead to more valued and appropriate alternative avenues of care and assistance for the older person.…”

Reasons for home care clients’ unplanned Hospital admissions and their associations with patient characteristics

“…malaise, dizziness, syncope, malnutrition); injuries; and other reasons (Appendix Table A1). The diagnosis groups were determined according to the previous studies concerning hospital care among old people (20,21) and to the authors' clinical experience. Final classification was reached by consensus between three experienced geriatricians.…”