Emergency department visits by nursing home residents in the United States.

摘要

OBJECTIVES: To characterize emergency department (ED) use by nursing home residents in the United States. DESIGN: Analysis of the National Hospital Ambulatory Medical Care Survey. SETTING: U.S. EDs from 2005 to 2008. PARTICIPANTS: Individuals visiting U.S. EDs stratified according to nursing home residency. MEASUREMENTS: All ED visits by nursing home residents were identified. The demographic and clinical characteristics and ED resource utilization, length of stay, and outcomes of nursing home residents and nonresidents were compared. RESULTS: During 2005 to 2008, nursing home residents accounted for 9,104,735 of 475,077,828 U.S. ED visits (1.9%; 95% confidence interval (CI) = 1.8-2.1%). The annualized number of ED visits by nursing home residents was 2,276,184. Most nursing home residents were older (mean age 76.7, 95% CI = 75.8-77.5), female (63.3%), and non-Hispanic white (74.8%). Nursing home residents were more likely to have been discharged from the hospital in the prior 7 days (adjusted odds ratio (aOR = 1.4, 95% CI = 1.1-1.9), to present with fever (aOR = 1.9, 95% CI = 1.5-2.4) or hypotension (systolic blood pressure