What Illness Lands the Most Seniors in the ER?
MONDAY, Jan. 28, 2019 (Pharmacist's Briefing) -- For seniors who often find themselves in the ER, complications from diabetes is the most common culprit, new research shows.
Not only that, these chronically ill patients remain in the hospital longer and require more treatment and resources, noted the authors of the study. It was published in the Jan. 28 issue of the Annals of Internal Medicine.
"Efforts to improve care for vulnerable older Americans should focus on enhancing delivery and decreasing utilization," said lead author Dr. Edward Castillo. He's an associate adjunct professor in the department of emergency medicine at the University of California, San Diego.
"Older patients are more likely to have multiple chronic conditions, which makes emergency care increasingly complex. A better understanding of older patients opens the door for interventions in and beyond the emergency department [ED]," Castillo explained in a journal news release.
The researchers examined 2014 data on California seniors defined as frequent users, meaning they visited an ED six times or more that year.
The most common conditions that took them to an emergency room were diabetes (26 percent), chronic pulmonary disease (21.5 percent), kidney disease (19 percent), congestive heart failure (16 percent), and peripheral vascular disease, or PAD (15 percent), which is blockage or damage to veins or arteries.
Compared to less frequent ED users, frequent users were more likely to have been admitted/transferred (86 percent vs. 44.6 percent) and to discontinue care (8 percent vs. 2 percent).
Frequent users were more likely to have more than one health problem, and 20 percent of them visited three or more hospitals during the study year.
"This study shows that there are opportunities for cost savings and more targeted preventive efforts across the care continuum for older patients," said study co-author Kelly Ko. He is director of clinical research at West Health, a nonprofit medical research organization.
"We can do more to help seniors stay healthier and potentially limit the number of times they have to visit the emergency department," Ko said.
In 2012, seniors accounted for 15 percent of the U.S. population but 21 percent of total health spending and almost half of the top 1 percent of spending, according to the Agency for Healthcare Research and Quality.
More than 15 percent of U.S. emergency department visits are made by patients 65 and older, according to the U.S. Centers for Disease Control and Prevention.
The American College of Emergency Physicians offers tips for taking seniors to the emergency department.