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Hospital characteristics and emergency department care of older patients are associated with return visits.
Acad Emerg Med. 2007 May; 14(5):426-33.AE

Abstract

OBJECTIVES

To explore hospital characteristics and indicators of emergency department (ED) care of older patients associated with return visits to the ED.

METHODS

Provincial databases in the province of Quebec, Canada, and a survey of ED geriatric services were linked at the individual and hospital level, respectively. All general acute care adult hospitals with at least 100 eligible patients who visited an ED during 2001 were included (N = 80). The study population (N = 140,379) comprised community-dwelling individuals aged 65 years and older who made an initial ED visit in 2001 and were discharged home. Characteristics of the hospitals included location, number of ED beds, ED resources, and geriatric services in the hospital and the ED. Indicators of ED care at the initial visit included day of the visit, availability of hospital beds, and relative crowding. The main outcome was time to first return ED visit; the authors also analyzed the type of return visit (with or without hospital admission at return visit, and return visits within seven days).

RESULTS

In multilevel multivariate analyses adjusting for patient characteristics (sociodemographic, ED diagnosis, comorbidity, prior health services utilization), the following variables were independently associated (p < 0.05) with a shorter time to first return ED visit: more limited ED resources, fewer than 12 ED beds, no geriatric unit, no social worker in the ED, fewer available hospital beds at the time of the ED visit, and an ED visit on a weekend.

CONCLUSIONS

In general, more limited ED resources and indicators of ED care (weekend visits, fewer available hospital beds) are associated with return ED visits in seniors, although the magnitude of the effects is generally small.

Authors+Show Affiliations

Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada. jane.mccusker@mcgill.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17369450

Citation

McCusker, Jane, et al. "Hospital Characteristics and Emergency Department Care of Older Patients Are Associated With Return Visits." Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, vol. 14, no. 5, 2007, pp. 426-33.
McCusker J, Ionescu-Ittu R, Ciampi A, et al. Hospital characteristics and emergency department care of older patients are associated with return visits. Acad Emerg Med. 2007;14(5):426-33.
McCusker, J., Ionescu-Ittu, R., Ciampi, A., Vadeboncoeur, A., Roberge, D., Larouche, D., Verdon, J., & Pineault, R. (2007). Hospital characteristics and emergency department care of older patients are associated with return visits. Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, 14(5), 426-33.
McCusker J, et al. Hospital Characteristics and Emergency Department Care of Older Patients Are Associated With Return Visits. Acad Emerg Med. 2007;14(5):426-33. PubMed PMID: 17369450.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hospital characteristics and emergency department care of older patients are associated with return visits. AU - McCusker,Jane, AU - Ionescu-Ittu,Raluca, AU - Ciampi,Antonio, AU - Vadeboncoeur,Alain, AU - Roberge,Danièle, AU - Larouche,Danielle, AU - Verdon,Josée, AU - Pineault,Raynald, Y1 - 2007/03/16/ PY - 2007/3/21/pubmed PY - 2007/5/22/medline PY - 2007/3/21/entrez SP - 426 EP - 33 JF - Academic emergency medicine : official journal of the Society for Academic Emergency Medicine JO - Acad Emerg Med VL - 14 IS - 5 N2 - OBJECTIVES: To explore hospital characteristics and indicators of emergency department (ED) care of older patients associated with return visits to the ED. METHODS: Provincial databases in the province of Quebec, Canada, and a survey of ED geriatric services were linked at the individual and hospital level, respectively. All general acute care adult hospitals with at least 100 eligible patients who visited an ED during 2001 were included (N = 80). The study population (N = 140,379) comprised community-dwelling individuals aged 65 years and older who made an initial ED visit in 2001 and were discharged home. Characteristics of the hospitals included location, number of ED beds, ED resources, and geriatric services in the hospital and the ED. Indicators of ED care at the initial visit included day of the visit, availability of hospital beds, and relative crowding. The main outcome was time to first return ED visit; the authors also analyzed the type of return visit (with or without hospital admission at return visit, and return visits within seven days). RESULTS: In multilevel multivariate analyses adjusting for patient characteristics (sociodemographic, ED diagnosis, comorbidity, prior health services utilization), the following variables were independently associated (p < 0.05) with a shorter time to first return ED visit: more limited ED resources, fewer than 12 ED beds, no geriatric unit, no social worker in the ED, fewer available hospital beds at the time of the ED visit, and an ED visit on a weekend. CONCLUSIONS: In general, more limited ED resources and indicators of ED care (weekend visits, fewer available hospital beds) are associated with return ED visits in seniors, although the magnitude of the effects is generally small. SN - 1553-2712 UR - https://www.unboundmedicine.com/medline/citation/17369450/Hospital_characteristics_and_emergency_department_care_of_older_patients_are_associated_with_return_visits_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=1069-6563&amp;date=2007&amp;volume=14&amp;issue=5&amp;spage=426 DB - PRIME DP - Unbound Medicine ER -