Emergency department admissions and economic costs burden related to ambulatory care sensitive conditions in older adults living in care homes.
Rev Clin Esp (Barc)
; 223(10): 585-595, 2023 Dec.
Article
em En
| MEDLINE
| ID: mdl-37838224
ABSTRACT
OBJECTIVES:
To assess the frequency of emergency department admissions (EDA) for ambulatory care sensitive conditions (ACSC) and non-ACSC among older adults living in care homes (CH), to describe and compare their demographic and clinical characteristics, the outcomes of the hospitalisation process and the associated costs.METHOD:
This multicenter, retrospective and observational study evaluated 2444 EDAs of older adults ≥ 65 years old living in care homes in 5 emergency departments in Catalonia (Spain) by ACSC and non-ACSC, in 2017. Sociodemographic variables, prior functional and cognitive status, and information on diagnosis and hospitalisation were collected. Additionally, the costs related with the EDAs were calculated, as well as a sensitivity analysis using different assumptions of decreased admissions due to ACSC.RESULTS:
A total of 2444 ED admissions were analysed. The patients' mean (SD) age was 85.9 (7.2) years. The frequency of ACSC-EDA and non-ACSC-EDA was 56.6% and 43.4%, respectively. Severe dependency and cognitive impairment were present in 56.6% and 78%, respectively, with no differences between the two groups. The three most frequent ACSC were falls/trauma (13.8%), chronic obstructive pulmonary disease/asthma (11.4%) and urinary tract infection (7.4%). The average cost per ACSC-EDA was Ñ1,408.24. Assuming a 60% reduction of ACSC-EDA, the estimated cost savings would be Ñ1.2 million.CONCLUSIONS:
Emergency admissions for ACSC from care homes have a significant impact on both frequency and costs. Reducing these conditions through targeted interventions could redirect the avoided costs towards improving care support in residential settings.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Doença Pulmonar Obstrutiva Crônica
/
Condições Sensíveis à Atenção Primária
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article