Emergency Department Visits by Older Adults with Mental Illness in North Carolina.

Anne Hakenewerth,Anna Waller,Judith Tintinalli,Amy Ising

doi:10.5811/westjem.2015.8.27662

Abstract

IntroductionWe analyzed emergency department (ED) visits by patients with mental health disorders (MHDs) in North Carolina from 2008–2010 to determine frequencies and characteristics of ED visits by older adults with MHDs.MethodsWe extracted ED visit data from the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT). We defined mental health visits as visits with a mental health ICD-9-CM diagnostic code, and organized MHDs into clinically similar groups for analysis.ResultsThose ≥65 with MHDs accounted for 27.3% of all MHD ED visits, and 51.2% were admitted. The most common MHD diagnoses for this age group were psychosis, and stress/anxiety/depression.ConclusionOlder adults with MHDs account for over one-quarter of ED patients with MHDs, and their numbers will continue to increase as the “boomer” population ages. We must anticipate and prepare for the MHD-related needs of the elderly.

Highlights

We analyzed emergency department (ED) visits by patients with mental health disorders (MHDs) in North Carolina from 2008-2010 to determine frequencies and characteristics of ED visits by older adults with MHDs
We defined mental health visits as visits with a mental health ICD-9-CM diagnostic code, and organized MHDs into clinically similar groups for analysis. Those ≥65 with MHDs accounted for 27.3% of all MHD ED visits, and 51.2% were admitted
Thirty-three percent (33%) of ED visits by all age groups with an MHD diagnostic code were admitted to the hospital, compared to 14% of all ED visits in North Carolina from 2008-2010

Summary

Introduction

We analyzed emergency department (ED) visits by patients with mental health disorders (MHDs) in North Carolina from 2008-2010 to determine frequencies and characteristics of ED visits by older adults with MHDs. Older patients with mental health disorders (MHDs) present to the emergency department (ED) with nursing, medical, environmental and social challenges. About 15% of those ≥60 years old have a MHD.[1] In the US, ED visits by patients ≥65 years old and ED visits by patients with MHDs are increasing.[2] The World Health Organization has identified the development of age-friendly services and settings as a treatment and care strategy for older adults with MHDs.[1] Quantifying ED visits by the elderly with MHDs is a first step in improving ED care for this group. We analyzed ED visits in North Carolina from 20082010 to determine the types and frequencies of ED visits by those ≥65 years old with MHDs, compared with similar ED visits by all other age groups during the same time period

Methods

Results

Discussion

Conclusion