To describe a community's experience with the use of emergency department services by nursing home residents.
We performed a retrospective chart review of a population-based cohort of nursing home residents in an urban county in central Georgia with 10 nursing homes (1,300 beds) and 4 hospital-based EDs.
All ED visits by nursing home residents during 1995 were analyzed.
Demographic data, timing of the visit, chief complaint, tests and treatments, disposition, and financial charges were recorded.
Further, we calculated the number of ED visits per 100 nursing home patient-years.
A total of 873 nursing home residents made 1,488 ED visits.
Mean age was 76.0 years ; 66.4% were female, and 55.2% were white.
Of the transfers, 42.9% occurred during regular working hours.
The most common chief complaints were respiratory symptoms (14.4%), altered mental status (10.1%), gastrointestinal symptoms (9.9%), and falls (8.2%) ; 101 patients (6.8%) were transferred for malfunction of a gastrostomy tube.
The most common laboratory tests were complete blood cell count (69.5%), chest radiograph (52.0%), electrocardiogram (45.0%), urinalysis (42.7%), and determination of electrolytes (42.7%). A total of 42.4% of the ED visits led to admission to the hospital.
From the 10 nursing homes, there were 110 ED visits per 100 patient-years.
A 3.5-fold difference in ED use among these nursing homes could not be explained by age, gender, or other factors. (...)
Mots-clés Pascal : Etablissement troisième âge, Etude comparative, Service urgence, Consultation, Heure, Age, Sexe, Symptomatologie, Diagnostic, Exploration clinique, Hospitalisation, Analyse coût, Etats Unis, Amérique du Nord, Amérique, Vieillard, Homme
Mots-clés Pascal anglais : Homes for the aged, Comparative study, Emergency department, Consultation, Hour, Age, Sex, Symptomatology, Diagnosis, Clinical investigation, Hospitalization, Cost analysis, United States, North America, America, Elderly, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0322304
Code Inist : 002B30A04A. Création : 27/11/1998.