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Health care utilization before and after an outpatient ED visit in older people.

Publication ,  Journal Article
Horney, C; Schmader, K; Sanders, LL; Heflin, M; Ragsdale, L; McConnell, E; Hocker, M; Hastings, SN
Published in: Am J Emerg Med
January 2012

BACKGROUND: Older adults in the United States receive a significant amount of care in the emergency department (ED), yet the associations between ED and other types of health care utilization have not been adequately studied in this population. OBJECTIVES: The goals of this study were to examine the relationships between health care use before and after an ED visit among older adults. METHODS: This retrospective cohort study examined health care use among 308 patients 65 years or older discharged from a university-affiliated ED. Proportional-hazards models were used to assess the relationship between pre-ED health care use (primary care physician [PCP], specialist, ED, and hospital) and risk of return ED visits. RESULTS: Older ED patients in this study had visited other types of providers frequently in the previous year (median number of PCP and specialist visits, 4). Patients who used the ED on 2 or more occasions in the previous year were found to have visited their PCP more often than those without frequent ED use (median number of visits, 7.0 vs 4.0; P < .001). Despite more PCP use in this population, frequent ED use was associated with increased risk of a repeat ED visit (hazard ratio, 2.20; 95% confidence interval, 1.15-4.21), in models adjusted for demographics and health status. CONCLUSION: Older adults who use the ED are also receiving significant amounts of care from other sources; simply providing additional access to care may not improve outcomes for these vulnerable individuals.

Duke Scholars

Published In

Am J Emerg Med

DOI

EISSN

1532-8171

Publication Date

January 2012

Volume

30

Issue

1

Start / End Page

135 / 142

Location

United States

Related Subject Headings

  • Statistics, Nonparametric
  • Severity of Illness Index
  • Retrospective Studies
  • Proportional Hazards Models
  • Male
  • Humans
  • Hospitalization
  • Female
  • Emergency Service, Hospital
  • Emergency & Critical Care Medicine
 

Citation

APA
Chicago
ICMJE
MLA
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Horney, C., Schmader, K., Sanders, L. L., Heflin, M., Ragsdale, L., McConnell, E., … Hastings, S. N. (2012). Health care utilization before and after an outpatient ED visit in older people. Am J Emerg Med, 30(1), 135–142. https://doi.org/10.1016/j.ajem.2010.10.036
Horney, Carolyn, Kenneth Schmader, Linda L. Sanders, Mitchell Heflin, Luna Ragsdale, Eleanor McConnell, Michael Hocker, and S Nicole Hastings. “Health care utilization before and after an outpatient ED visit in older people.Am J Emerg Med 30, no. 1 (January 2012): 135–42. https://doi.org/10.1016/j.ajem.2010.10.036.
Horney C, Schmader K, Sanders LL, Heflin M, Ragsdale L, McConnell E, et al. Health care utilization before and after an outpatient ED visit in older people. Am J Emerg Med. 2012 Jan;30(1):135–42.
Horney, Carolyn, et al. “Health care utilization before and after an outpatient ED visit in older people.Am J Emerg Med, vol. 30, no. 1, Jan. 2012, pp. 135–42. Pubmed, doi:10.1016/j.ajem.2010.10.036.
Horney C, Schmader K, Sanders LL, Heflin M, Ragsdale L, McConnell E, Hocker M, Hastings SN. Health care utilization before and after an outpatient ED visit in older people. Am J Emerg Med. 2012 Jan;30(1):135–142.
Journal cover image

Published In

Am J Emerg Med

DOI

EISSN

1532-8171

Publication Date

January 2012

Volume

30

Issue

1

Start / End Page

135 / 142

Location

United States

Related Subject Headings

  • Statistics, Nonparametric
  • Severity of Illness Index
  • Retrospective Studies
  • Proportional Hazards Models
  • Male
  • Humans
  • Hospitalization
  • Female
  • Emergency Service, Hospital
  • Emergency & Critical Care Medicine