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Caregiver Burden and 30-Day Emergency Department Revisits
Nathalie Germain1,2,3, Annie Toulouse-Fournier1,3, Rawane Samb1
1Centre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Lévis, Québec, Canada.
JAMA Network Open
|September 9, 2025
Summary
Caregiver burden in older adults is linked to emergency department (ED) revisits within 30 days. Addressing caregiver stress may reduce readmissions and improve care transitions for elderly patients.
Area of Science:
- Gerontology and Geriatric Care
- Emergency Medicine and Healthcare Management
- Public Health and Health Services Research
Background:
- Caregivers for community-dwelling older adults are crucial for successful emergency department (ED) care transitions.
- Increased caregiver burden can precipitate ED returns for older adults.
- Understanding the link between caregiver burden and ED revisits is vital for improving patient outcomes and healthcare resource utilization.
Purpose of the Study:
- To investigate the association between caregiver burden and emergency department (ED) revisits and hospital admissions within 30 days post-discharge.
- To develop predictive models for ED revisits based on caregiver burden in older adult populations.
- To explore potential moderation effects of COVID-19 pandemic waves on these associations.
Main Methods:
- A prospective cohort study involving 1409 dyads of community-dwelling older adults (≥65 years) and their caregivers.
- Caregiver burden was assessed using the Zarit Burden Interview (ZBI).
- Outcomes included ED revisits within 3, 7, and 30 days, and ED revisits resulting in hospitalization within 30 days.
Main Results:
- Each one-point increase in caregiver burden (ZBI score) was associated with a 3% increase in the odds of a 30-day ED revisit (OR, 1.03; P=.03).
- No significant associations were found for shorter revisit windows (3 or 7 days) or for revisits leading to hospitalization.
- The association between caregiver burden and 30-day ED revisits was potentially moderated by COVID-19 pandemic waves, notably reversed during the first interwave period.
Conclusions:
- Caregiver burden appears to be a significant factor associated with 30-day emergency department revisits for community-dwelling older adults.
- These findings underscore the importance of assessing and supporting caregivers to potentially mitigate ED readmissions.
- Further research is warranted to elucidate the longitudinal impact of caregiver burden on ED utilization in older adults and inform targeted interventions.
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