Do EDs help or harm older patients?

Emergency departments negatively affect older patients whose complex conditions worsen after their visits, according to a study published in the June 25 issue of Annals of Emergency Medicine.

Researchers from the Centre for Research in Geriatric Medicine at the University of Queensland, Australia, studied 2,282 patients ages 75 years or older in 13 EDs in seven countries, tracking patients' progress for 28 days post-ED visit.

Before arriving, 46 percent of the elderly patients required help for daily activities--a number that rose to 67 percent at the ED. Moreover, about 48 percent of patients already had a geriatric syndrome, such as immobility, confusion and incontinence, before visiting the ED. And after, about 78 percent had a geriatric syndrome, according to the study.

Hospital should take note, given Medicare patients are receiving services in hospital EDs at greater rates and require more intensive care than only a few years ago, according to a May study by the American Hospital Association.

With an aging, sicker population, the Annals of Emergency Medicine study suggests hospitals should tailor EDs to the medical needs of elderly patients, Kaiser Health News reported.

"It seems not a matter of 'if,' but rather 'when' adjustments should be made," lead author Leonard C. Gray, M.D., told KHN. Those ED adjustments could involve furniture or lighting changes or staff training and risk minimization.

For more:
- here's the study abstract
- read the KHN article