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Health services use of older veterans treated and released from veterans affairs medical center emergency departments.

Publication ,  Journal Article
Hastings, SN; Smith, VA; Weinberger, M; Oddone, EZ; Olsen, MK; Schmader, KE
Published in: J Am Geriatr Soc
September 2013

OBJECTIVES: To determine predictors of repeat health service use in older veterans treated and released from the emergency department (ED). DESIGN: Retrospective cohort study. SETTING: Veterans Affairs Medical Center (VAMC) EDs. PARTICIPANTS: Nationally representative sample of veterans aged 65 and older treated and released from one of 102 VAMC EDs between October 1, 2007, and June 30, 2008. MEASUREMENTS: Logistic regression models were used to examine the association between independent variables and primary outcomes (30-day repeat ED visits and hospital admissions). RESULTS: In 31,206 older veterans, ED diagnoses were commonly related to chronic conditions (22.5%), injuries and acute musculoskeletal conditions (19%), and infections (13.5%). Within 30 days, 22% of older veterans had returned to the ED (n = 4,779) or been hospitalized (n = 2,005). In adjusted models, factors associated with greater odds of repeat ED visits than injury were homelessness (odds ratio (OR) = 1.6, 95% confidence interval (CI) = 1.3-2.1), previous ED visits (OR = 1.7, 95% CI = 1.6-1.8), previous hospitalization (OR = 1.3, 95% CI = 1.2-1.4), and index ED visit related to infection (1.2, 95% CI = 1.1-1.3). Odds of subsequent hospital admission were higher in veterans with previous hospitalization (OR = 2.5, 95% CI = 2.2-2.8), who were homeless (OR = 1.5, 95% CI = 1.1-2.0), who had aid and attendance benefits (OR = 1.5, 95% CI = 1.2-1.8), who were unmarried (OR = 1.2, 95% CI = 1.1-1.3), and who had an ED visit related to a chronic condition (OR = 1.4, 95% CI = 1.2-1.6) than in those with injury. CONCLUSION: A substantial proportion of older veterans treated and released from a VAMC ED returned to the ED or were hospitalized within 30 days. Intervening with high-risk older veterans after an ED visit may reduce unscheduled healthcare use.

Duke Scholars

Published In

J Am Geriatr Soc

DOI

EISSN

1532-5415

Publication Date

September 2013

Volume

61

Issue

9

Start / End Page

1515 / 1521

Location

United States

Related Subject Headings

  • Veterans
  • United States
  • Retrospective Studies
  • Patient Discharge
  • Humans
  • Hospitals, Veterans
  • Health Services for the Aged
  • Geriatrics
  • Follow-Up Studies
  • Emergency Service, Hospital
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Hastings, S. N., Smith, V. A., Weinberger, M., Oddone, E. Z., Olsen, M. K., & Schmader, K. E. (2013). Health services use of older veterans treated and released from veterans affairs medical center emergency departments. J Am Geriatr Soc, 61(9), 1515–1521. https://doi.org/10.1111/jgs.12417
Hastings, Susan Nicole, Valerie A. Smith, Morris Weinberger, Eugene Z. Oddone, Maren K. Olsen, and Kenneth E. Schmader. “Health services use of older veterans treated and released from veterans affairs medical center emergency departments.J Am Geriatr Soc 61, no. 9 (September 2013): 1515–21. https://doi.org/10.1111/jgs.12417.
Hastings SN, Smith VA, Weinberger M, Oddone EZ, Olsen MK, Schmader KE. Health services use of older veterans treated and released from veterans affairs medical center emergency departments. J Am Geriatr Soc. 2013 Sep;61(9):1515–21.
Hastings, Susan Nicole, et al. “Health services use of older veterans treated and released from veterans affairs medical center emergency departments.J Am Geriatr Soc, vol. 61, no. 9, Sept. 2013, pp. 1515–21. Pubmed, doi:10.1111/jgs.12417.
Hastings SN, Smith VA, Weinberger M, Oddone EZ, Olsen MK, Schmader KE. Health services use of older veterans treated and released from veterans affairs medical center emergency departments. J Am Geriatr Soc. 2013 Sep;61(9):1515–1521.
Journal cover image

Published In

J Am Geriatr Soc

DOI

EISSN

1532-5415

Publication Date

September 2013

Volume

61

Issue

9

Start / End Page

1515 / 1521

Location

United States

Related Subject Headings

  • Veterans
  • United States
  • Retrospective Studies
  • Patient Discharge
  • Humans
  • Hospitals, Veterans
  • Health Services for the Aged
  • Geriatrics
  • Follow-Up Studies
  • Emergency Service, Hospital