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How to reduce erroneous Emergency Department admissions for the frail elderly
G Guarducci1, C Lorenzini1, D Ciacci2
1Post Graduate School of Public Health, University of Siena, Italy.
Annali Di Igiene : Medicina Preventiva E Di Comunita
|May 23, 2023
Summary
Elderly patients living farther from hospitals face higher readmission risks. Identifying these factors can help reduce emergency department visits and improve care coordination for frequent users.
Area of Science:
- Geriatric Medicine
- Public Health
- Health Services Research
Background:
- Hospital readmissions are common, especially among elderly patients.
- Potential causes include incomplete treatment, poor management of chronic conditions, and fragmented care post-discharge.
- Identifying factors contributing to readmission is crucial for improving patient outcomes and healthcare efficiency.
Purpose of the Study:
- To identify factors associated with hospital readmissions in elderly patients.
- To classify pathologies leading to unplanned Emergency/Urgency Department (EUD) access after discharge.
- To understand the role of patient residence proximity in readmission risk.
Main Methods:
- Retrospective observational study of 1,230 patients with at least one EUD readmission within six months of discharge.
- Data collected from January 2016 to December 2019 at the University Hospital of Siena.
- Analysis included patient demographics, residence, and ICD-9-CM coded diagnoses, with statistical analysis using Stata software.
Main Results:
- The study included 1,230 patients, with a mean age of 78.2 years; 58.6% were 80 years or older.
- Patients residing farther from the hospital showed a higher probability of readmission (OR 0.76).
- Leading causes for readmission in patients aged 65+ included ill-defined conditions (18.3%), respiratory diseases (15.0%), and injuries (14.1%).
Conclusions:
- Geographic distance from healthcare facilities is a significant factor influencing hospital readmission risk in elderly patients.
- Identifying high-risk patients based on these factors can inform targeted interventions.
- Proactive measures are needed to reduce avoidable emergency department visits and improve post-discharge care coordination.
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