It comes as no surprise to learn that older people use hospital emergency rooms (ERs) more than other groups. But it might come as a surprise to learn that the number one condition found in seniors who use the ER is diabetes, according to a new study published in the Annals of Emergency Medicine.
The researchers’ analysis was based on data from more than 1.25 million patients over 65 who visited more than 300 hospitals. The researchers were interested in collecting information on people classified as “frequent users” of ERs. Frequent users were defined as those using an ER six or more times in a year (some of the patients made as many as 20 visits). Another factor in the investigation was what are known as “comorbidities.” A comorbidity is defined as the presence of one or more additional diseases or disorders in addition to a primary one.
Although only about 6 percent of the people in the database were classified as frequent users, they accounted for more than 20 percent of the ER visits. The researchers included 17 clinical conditions in their analysis and found that the most common comorbidity among the ER users was diabetes (25.8 percent of frequent users). The other leading comorbidities were lung disease (21.5 percent), kidney disease (19.1), congestive heart failure (16.0) and peripheral vascular disease (15.1). The research also showed that these were the most common comorbidities whether or not the patients were frequent users.
To address the issue, the researchers stressed the value of “interventions” — measures taken in advance to make ER visits less likely. According to study co-author Kelly J. Ko, PhD, “This study shows that there are opportunities for both cost savings and more targeted interventions to help improve outcomes for senior in the emergency department….” Edward M. Castillo, PhD, MPH, lead author of the study, agreed that refining interventions can improve care, enhance delivery and decrease use of the ER. As he put it, “Older patients are more likely to have multiple chronic conditions, which makes emergency care increasingly complex. A better understanding of older patients opens the door for interventions in and beyond the emergency department.”