Abstract
BackgroundAge increases the risk of emergency department [ED] visits. Health related quality of life (HRQoL) is often estimated as an outcome of ED visits, but it can be a risk factor of ED visits. This study aims to assess the association of HRQoL with time to first ED visit and/or frequent ED use in older adults during four-year period and if this association differs in 66–80 and 80+ age groups.MethodsData from the Swedish National Study on Aging and Care-Blekinge of wave 2007–2009 was used in combination with electronic health records on ED visits. The analytical sample included 673 participants of age 66 years and older with information on HRQoL. Cox proportional hazard model was used to assess the association between HRQoL and time to first ED visit. Logistic regression analysis was performed to estimate the association of HRQoL with frequent ED use.ResultsDuring the study period, 55.3% of older adults visited the ED and 28.8% had a frequent ED use. Poor physical HRQoL was independently associated with first ED visit both in total sample (p < 0.001) and in 66–80 (p < 0.001) and 80+ (p = 0.038) age groups. Poor mental HRQoL had no significant association with first ED visit and frequent ED use.ConclusionFindings suggest that poor physical HRQoL is associated with time to first ED visit in older adults. Therefore, physical HRQoL should be considered while planning interventions on the reduction of ED utilisation in older adults. Explanatory factors of frequent ED use may differ in age groups. Further studies are needed to identify associated factors of frequent ED visits in 80+ group.
Highlights
Age increases the risk of emergency department [ED] visits
The mean scores of physical and mental Health related quality of life (HRQoL) were significantly lower in the 80+ age group compared to the 66–80 age group, and the percentages of participants with poor physical and mental HRQoL were higher in the 80+ group than 66–80 group (p < .001) (Table 1)
This study identified different explanatory variables of ED visits specific to each age group
Summary
Health related quality of life (HRQoL) is often estimated as an outcome of ED visits, but it can be a risk factor of ED visits. The emergency department (ED) is often an inappropriate setting for the older people with complex health problems, because of its stressful environment, long length of stay, and poor continuity of care. According to the Swedish National Board of Health and Welfare [3], age is an important factor for longer length of stay at ED. This points towards the importance of determining age-specific contributing factors of ED visits in order to prevent avoidable acute visits. Subjective perceptions of Health Related Quality of Life (HRQoL) can be a predictive of acute health care utilisation
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