In the Journals

Frequent ED visits common for older adults with diabetes

Diabetes is the most common disease classification for adults aged at least 65 years who are frequently admitted to hospital EDs, according to findings published in the Annals of Emergency Medicine.

“The ED’s role in delivering care for a large proportion of the population is expanding, especially for older and sicker patients,” Edward M. Castillo, PhD, MPH, an associate adjunct professor in the department of emergency medicine at the University of California, San Diego, and colleagues wrote. “In comparison to other age groups, older adults use the ED at a higher rate, have longer stays in the ED, and require more resources and medical interventions during their visit.”

Castillo and colleagues conducted a multicenter retrospective cohort study using data from 326 licensed, nonfederal California hospitals. Included patients were aged at least 65 years and had at least one visit to the ED in 2014, with the researchers also identifying visits in the previous year. Patients were considered frequent users if they visited the ED at least six times in a 365-day period.

Of the 1,259,809 included patients, 5.6% (70,300) were classified as frequent users and made up 19.9% of all ED visits in the study period. According to the researchers, diabetes was the most common disease classification for an ED visit (n = 325,793; 25.8% of all visits), followed by chronic pulmonary disease (n = 270,370; 21.5%), renal disease (n = 240,379; 19.1%), congestive heart failure (n = 201,656; 16%) and peripheral vascular disease (n = 189,708; 15.1%). Frequent ED visits were most closely associated with pain-related diagnoses (OR = 5.5; 95% CI, 5.4-5.6) and injury-related events (OR = 3.8; 95% CI, 3.8-3.9).

“There has been an increased focus on health care in the aging population, which is leading to specialty geriatric EDs and focused interventions to improve health care delivery and decrease health care use,” the researchers wrote. “Our findings provide an opportunity to help improve the care of geriatric patients who frequently use acute care services by highlighting specific needs of this population.” – by Phil Neuffer

Disclosures: The authors report no relevant financial disclosures.

Diabetes is the most common disease classification for adults aged at least 65 years who are frequently admitted to hospital EDs, according to findings published in the Annals of Emergency Medicine.

“The ED’s role in delivering care for a large proportion of the population is expanding, especially for older and sicker patients,” Edward M. Castillo, PhD, MPH, an associate adjunct professor in the department of emergency medicine at the University of California, San Diego, and colleagues wrote. “In comparison to other age groups, older adults use the ED at a higher rate, have longer stays in the ED, and require more resources and medical interventions during their visit.”

Castillo and colleagues conducted a multicenter retrospective cohort study using data from 326 licensed, nonfederal California hospitals. Included patients were aged at least 65 years and had at least one visit to the ED in 2014, with the researchers also identifying visits in the previous year. Patients were considered frequent users if they visited the ED at least six times in a 365-day period.

Of the 1,259,809 included patients, 5.6% (70,300) were classified as frequent users and made up 19.9% of all ED visits in the study period. According to the researchers, diabetes was the most common disease classification for an ED visit (n = 325,793; 25.8% of all visits), followed by chronic pulmonary disease (n = 270,370; 21.5%), renal disease (n = 240,379; 19.1%), congestive heart failure (n = 201,656; 16%) and peripheral vascular disease (n = 189,708; 15.1%). Frequent ED visits were most closely associated with pain-related diagnoses (OR = 5.5; 95% CI, 5.4-5.6) and injury-related events (OR = 3.8; 95% CI, 3.8-3.9).

“There has been an increased focus on health care in the aging population, which is leading to specialty geriatric EDs and focused interventions to improve health care delivery and decrease health care use,” the researchers wrote. “Our findings provide an opportunity to help improve the care of geriatric patients who frequently use acute care services by highlighting specific needs of this population.” – by Phil Neuffer

Disclosures: The authors report no relevant financial disclosures.