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. 2022 Nov;22(11):917-923.
doi: 10.1111/ggi.14481. Epub 2022 Sep 18.

Association of age with emergency department visits and hospital admissions: A nationwide study

Filippo Luca Fimognari  1 , Diana Lelli  2 , Francesco Landi  3 , Raffaele Antonelli Incalzi  2
Affiliations

Association of age with emergency department visits and hospital admissions: A nationwide study

Filippo Luca Fimognari et al. Geriatr Gerontol Int. 2022 Nov.

Abstract

Aim: Older adults are frequently stigmatized for improper emergency department (ED) visits and hospitalizations. In this study, we aimed to investigate the relationship between age and appropriateness of ED visits, and the mismatching between ED clinical severity and hospitalizations.

Methods: We carried out a nationwide assessment of Italian Informative System for the Emergency and Urgency data from 1 January 2015 to 31 December 2015 including patients admitted to all the Italian EDs for any reason. Appropriateness of ED visits was defined as a yellow/red/black color code (potentially life-threatening/dead patients), whereas clinical severity/hospitalization mismatching was defined as hospital admission after validated ED green/white codes. Analyses dedicated to people aged ≥75 years were carried out.

Results: There were 20 400 071 ED visits (3 444 091 aged ≥75 years), which increased with age, up to >650/1000 inhabitants aged ≥90 years. The appropriateness of ED visits increased with age, from 6.3% in the 5-9 years age group to 44.2% in the 95-99 years age group. Clinical severity/hospitalization mismatching decreased with age, from 62.9% in the 30-34 years age group to 27.7% in the 95-99 years age group. At ED presentation, 21.6% of patients aged ≥75 years complained of non-specific symptoms, and hospital discharge diagnoses frequently differed from the ED admission diagnoses; 11.4% died during hospitalization and 8.8% were discharged to long-term care facilities.

Conclusions: The request for ED care and the admission to acute care ward are commonly appropriate for older patients. Clinical presentation at ED admission is frequently atypical. Health care systems should aim at improving outpatients' management to reduce the ED care need, but also at optimizing in-hospital strategies and pathways for older adults. Geriatr Gerontol Int 2022; 22: 917-923.

Keywords: emergency medical services; hospitalization; older adults; triage.

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References

    1. Legramante JM, Morciano L, Lucaroni F et al. Frequent Use of Emergency Departments by the Elderly Population When Continuing Care Is Not Well Established. PLoS One 2016; 11: e0165939.
    1. Salvi F, Morichi V, Grilli A, Giorgi R, De Tommaso G, Dessì-Fulgheri P. The elderly in the emergency department: a critical review of problems and solutions. Intern Emerg Med 2007; 2: 292-301.
    1. Gasperini B, Cherubini A, Pierri F, Barbadoro P, Fedecostante M, Prospero E. Potentially preventable visits to the emergency department in older adults: Results from a national survey in Italy. PLoS One 2017; 12: e0189925.
    1. Pines JM, Mullins PM, Cooper JK, Feng LB, Roth KE. National trends in emergency department use, care patterns, and quality of care of older adults in the United States. J Am Geriatr Soc 2013; 61: 12-17.
    1. Gruneir A, Silver MJ, Rochon PA. Emergency department use by older adults: a literature review on trends, appropriateness, and consequences of unmet health care needs. Med Care Res Rev 2011; 68: 131-155.

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