Nearly 5 percent of older Medicare beneficiaries seen in the emergency department have a hospital inpatient admission within seven days after discharge, according to a study published in the January issue of the Journal of the American Geriatrics Society.
Gelareh Z. Gabayan, M.D., from the University of California in Los Angeles, and colleagues evaluated emergency department visits for 505,315 Medicare beneficiaries (≥65 years) in 2007 using the California Office of Statewide Health Planning and Development files. The authors sought to identify predictors of hospital inpatient admission within seven days of emergency department discharge in older adults.
The researchers found that hospital inpatient admissions within seven days of emergency department discharge occurred in 4.6 percent of visits and were associated with older age (adjusted odds ratios [aORs] for 70 to 74, 75 to 79, and ≥80 years: 1.12, 1.18, and 1.4, respectively), skilled nursing facility use (aOR, 1.82), and leaving the emergency department against medical advice (aOR, 1.82). Additionally, certain diagnoses were associated with the highest odds of admission: end-stage renal disease (aOR, 3.83), chronic renal disease (aOR, 3.19), and congestive heart failure (aOR, 3.01).
“Five percent of older Medicare beneficiaries have a hospital inpatient admission after discharge from the emergency department,” the authors write.