title: Trends in short-stay hospitalizations for older adults from 1990 to 2010: implications for geriatric emergency care.
abstract: BACKGROUND
  Geriatric patients are more likely than younger patients to be admitted to the hospital when they present to the emergency department (ED). Identifying trends in geriatric short-stay admission may inform the development of interventions designed to improve acute care for the elderly.
  
  
  OBJECTIVE
  To evaluate trends in US geriatric short-stay hospitalizations from 1990 to 2010.
  
  
  METHODS
  Retrospective study using the National Hospital Discharge Survey (NHDS). Trends in short-stay hospitalizations were analyzed from 1990 to 2010 for age groups 22 to 64, 65 to 74, 75 to 84, and at least 85 years using linear regression.
  
  
  RESULTS
  A total of 4.5 million survey visits representing 580 million adult hospitalizations were available for analysis; 250 million (43%) were among patients 65 years or older. Of these, 12%, 25%, and 40% were ≤ 1, ≤ 2 and ≤ 3 days' short-stay admissions, respectively. Between 1990 and 2010, short-stay admissions increased as a percentage of total hospitalizations for each geriatric age group but remained relatively constant for younger adults. Admissions from NHDS were similar to admissions from the ED for years where ED-specific data were available. The older a patient was (age >65 years), the more likely their admission was to have started in the ED.
  
  
  CONCLUSIONS
  For all elderly patients, short-stay admissions represented a growing proportion of total admissions, regardless of the definition of short stay. These trends were identified despite the NHDS exclusion of observation status hospitalizations. The increase in short-stay admissions was the most pronounced in the extreme elderly (age ≥ 85 years). Future research is needed to optimize treatment for geriatric patients presenting to the ED, some of whom, with brief observation and appropriate follow-up, may be better cared for without hospitalization.
authors: Emergency Department, Weill Cornell Medical College, New York, NY. Electronic address: pg2014@columbia.edu.
authors: Peter W
authors: PW
authors: Greenwald
authors: Emergency Department, Weill Cornell Medical College, New York, NY.
authors: Michael E
authors: ME
authors: Stern
authors: Emergency Medicine Residency, New York Presbyterian Hospital, New York, NY.
authors: Tony
authors: T
authors: Rosen
authors: Emergency Department, Weill Cornell Medical College, New York, NY.
authors: Sunday
authors: S
authors: Clark
authors: Emergency Department, Weill Cornell Medical College, New York, NY.
authors: Neal
authors: N
authors: Flomenbaum
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data / Q000639:trends*; D005853:Geriatrics; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000639:trends*; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States