Risk factors for frequent users of the emergency department among adults aged 55 and older

Abstract

Introduction: Excessive use of the emergency department (ED) is a major source of healthcare expenditure. ED frequent users, have been identified as a major contributing factor to a disporportionate amount of ED visits and costs, making up 20% to 30% of all annual visits. The aim of the study was to identify risk factors that place adults age 55 and older at risk for frequent ED use. Methods: The Transitional Care Model (TCM): Hospital Discharge Screening Criteria for High Risk Older Adults was used to identify risk factors for frequent use of ED services in adults 55 and older. Results and conclusions: A third of the sample (33%) had active behavioral and/or psychiatric issues. A majority of the sample (87%) had two or more hospitalizations within 6 months of a prior ED visit, and seventy-two percent were hospitalized within thirty days of an Emergency Department visit. Almost 70% had at least 1 chronic diagnosis of diabetes (41.5%), heart failure (35.8%), or COPD (28%). Most patients were between ages 70-85 years old and risk factors for ED frequent use included 4 or more coexisting health conditions, 6 or more prescription medications, previous hospital admissions, active behavioral and/or psychiatric issues. Identifying older adults at high risk for ED frequent use may provide earlier interventions and less reliance on ED use for care and treatment of chronic disorders.