J Korean Soc Emerg Med.  2017 Feb;28(1):87-96. 10.0000/jksem.2017.28.1.87.

Analysis of Epidemiologic Characteristics between Patients Visited from Residential Aged Care Facilities and Elderly Patients Visited from Home Admitted to the Emergency Department with Disease

• Ham EM
• Kim HB
• Pyo CH
• Park SH
• Park KH
• Kwak MK
• Shin SY
• Oh SB
• Choi HJ

• KMID: 2425182
• DOI: http://doi.org/10.0000/jksem.2017.28.1.87

Abstract

PURPOSE
In recent years, the number of elderly patients visiting from residential aged care facilities (RACFs) has been increasing. We analyzed a comparison of characteristics between patients who visited the ER with diseases from RACFs and those who visited from home.
METHODS
A retrospective study was conducted in a public hospital between January 2013 and December 2014. The subjects included patients who visited the ED from RACFs and elderly patients who visited the ED from home. Comparisons of the following parameters were made between the two groups: gender, age, mode of insurance, mode of ED visit, mobile status, Charlson comorbidity index (CCI), chief complaint, final results in the ED, and length of stay (LOS) in the ED and hospital.
RESULTS
A total of 7,603 patients were enrolled during the study period. There were 6,401 elderly patients who visited from home and 1,202 patients who visited from RACFs. Patients from RACFs were older than those from home (79.90±8.01 vs. 75.78±7.26, p<0.001). More patients from RACFs were on Medicaid (56.6% vs. 27.9%, p<0.001), took more ambulance (86.3% vs. 49.4%, p<0.001), more bedridden (68.2% vs. 6.4%, p<0.001), and higher CCI (2.38±1.99 vs. 1.45±1.84, p<0.001). Compared with patients from home, those from RACFs showed a significantly higher proportion of admission (63.2% vs. 32.9%, p<0.001), ED LOS (403.03±361.77 vs. 277.07±258.82, p<0.001), and hospital LOS (19.65±18.58 vs. 15.67±15.63, p<0.001). Patients from RACFs showed especially longer ED LOS from discharged ED than those from home (388.87±422.88 vs. 221.90±215.30, p<0.001).
CONCLUSION
Compared with elderly patients from home, patients from RACFs also had higher admission rate and longer ED LOS, as well as hospital LOS. Patients from RACFs had long ED LOS. The findings in this study suggest that there could be ED overcrowding in the near future.

Keyword

Emergency service; Hospital; Aged; Residential facilities; Nursing homes

MeSH Terms

Aged*
Ambulances
Comorbidity
Emergencies*
Emergency Service, Hospital*
Hospitals, Public
Humans
Insurance
Length of Stay
Medicaid
Nursing Homes
Residential Facilities
Retrospective Studies