Survey of major chronic iIlnesses and hospital admissions via the emergency department in a randomized older population in Randwick, Australia.
OBJECTIVE
To find out if patients with chronic illnesses living in the community are at risk of unplanned hospital admissions through emergency departments; what types of chronic illnesses may be putative risk factors; and if an increase in the number of chronic illnesses may be associated with increased risk.


METHODS
The survey included the completion of a standardized questionnaire for medical illnesses in a random sample of older people dwelling in the community and analysis of admission records to our hospital. The principal diagnoses for admissions were recorded. The risk factors for admissions were analysed.


RESULTS
Five hundred and twenty-six (239 men and 287 women) people aged 55 years and over were interviewed. Musculoskeletal disorders, hypertension, gastrointestinal disorders and ischaemic heart disease were the most frequently reported of the chronic illnesses surveyed. A total number of 70 people from the survey group with a total of 115 admissions through emergency departments were recorded. Using logistic regression model, hypertension, ischaemic heart disease and age were found to be risk factors for emergency admissions amongst this group of community-dwelling residents. The ratios were 2.03 (95% confidence interval (CI): 1.2-3.44), 2.02 (95% CI: 1.16-3.49) and 1.05 (95% CI: 1.02-1.09), respectively. Furthermore, multiple (three or more) chronic illnesses were found to be a strong predictor of hospital admission via emergency department (chi-square = 16.647, DF = 1, P-value < 0.001).


CONCLUSIONS
We conclude that there was significant association between multiple chronic diseases and emergency admissions for older people. Of these, hypertension and ischaemic heart disease were found to be significant predictors. Age per se was found to be of borderline significance.
Chan
Daniel K Y
DK
Department of Aged Care and Rehabilitation, Bankstown Hospital, Elridge Rd, NSW 2200, Australia. d.chan@unsw.edu.au
Chong
Robert
R
Basilikas
Jim
J
Mathie
Merryn
M
Hung
Wai Tak
WT
D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology* / Q000628:therapy; D015897:Comorbidity; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010343:Patient Admission / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution