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Frequency and Pattern of Emergency Department Visits by Long‐Term Care Residents—A Population‐Based Study
Author(s) -
Gruneir Andrea,
Bell Chaim M.,
Bronskill Susan E.,
Schull Michael,
Anderson Geoffrey M.,
Rochon Paula A.
Publication year - 2010
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2010.02736.x
Subject(s) - medicine , emergency department , triage , emergency medicine , ambulatory , population , long term care , ambulatory care , retrospective cohort study , cohort , pediatrics , medical emergency , health care , nursing , environmental health , psychiatry , economics , economic growth
OBJECTIVES: To obtain population‐based estimates of emergency department (ED) visits by long‐term care (LTC) residents. DESIGN: Retrospective cohort study using administrative data. SETTING: All LTC facilities in Ontario, Canada. PARTICIPANTS: All LTC residents who visited an ED at least once during a 6‐month period. MEASUREMENTS: All ED visits were described using the National Ambulatory Care Reporting System. Two distinct visit types were defined. Potentially preventable visits were defined as those for any ambulatory care sensitive condition; these are conditions for which exacerbations that result in hospital use suggest lack of access to adequate primary care. Low‐acuity visits were defined as those triaged as nonurgent at ED registration and ended with return to the LTC facility without hospital admission. RESULTS: Nearly one‐quarter of LTC residents visited the ED at least once in 6 months. Of all visits, 24.6% were for a potentially preventable reason, most commonly pneumonia, urinary tract infection, and congestive heart failure. These visits had a high frequency of ambulance transport (90.4%), emergent triage (35.3%), hospital admission (62.4%), and death within 30 days (23.6%). Of all visits, 11.0% were low acuity. Fall‐related injury was the most common cause. Low‐acuity visits were the shortest (mean length 4.5 ± 4.0 hours) and had the lowest frequency of death within 30 days (4.3%). CONCLUSION: LTC residents made frequent visits to the ED. The visit types showed distinct patterns that suggest a need for better access to medical care for common conditions and a greater emphasis on fall prevention in LTC.