Trends in short-stay hospitalizations for older adults from 1990 to 2010: implications for geriatric emergency care.

Publication Type Academic Article
Authors Greenwald P, Stern M, Rosen T, Clark S, Flomenbaum N
Journal Am J Emerg Med
Volume 32
Issue 4
Pagination 311-4
Date Published 12/11/2013
ISSN 1532-8171
Keywords Emergency Service, Hospital, Geriatrics, Hospitalization, Length of Stay
Abstract INTRODUCTION: Geriatric patients are more likely than younger patients to be admitted to the hospital when they present to the emergency department (ED). Identifying trends in geriatric short-stay admission may inform the development of interventions designed to improve acute care for the elderly. OBJECTIVE: To evaluate trends in US geriatric short-stay hospitalizations from 1990 to 2010. METHODS: Retrospective study using the National Hospital Discharge Survey (NHDS). Trends in short-stay hospitalizations were analyzed from 1990 to 2010 for age groups 22 to 64, 65 to 74, 75 to 84, and at least 85 years using linear regression. RESULTS: A total of 4.5 million survey visits representing 580 million adult hospitalizations were available for analysis; 250 million (43%) were among patients 65 years or older. Of these, 12%, 25%, and 40% were ≤ 1, ≤ 2 and ≤ 3 days' short-stay admissions, respectively. Between 1990 and 2010, short-stay admissions increased as a percentage of total hospitalizations for each geriatric age group but remained relatively constant for younger adults. Admissions from NHDS were similar to admissions from the ED for years where ED-specific data were available. The older a patient was (age >65 years), the more likely their admission was to have started in the ED. DISCUSSION: For all elderly patients, short-stay admissions represented a growing proportion of total admissions, regardless of the definition of short stay. These trends were identified despite the NHDS exclusion of observation status hospitalizations. The increase in short-stay admissions was the most pronounced in the extreme elderly (age ≥ 85 years). Future research is needed to optimize treatment for geriatric patients presenting to the ED, some of whom, with brief observation and appropriate follow-up, may be better cared for without hospitalization.
DOI 10.1016/j.ajem.2013.12.011
PubMed ID 24512885
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