title: Predictors of admission after emergency department discharge in older adults.
abstract: OBJECTIVE
  To identify predictors of hospital inpatient admission of older Medicare beneficiaries after discharge from the emergency department (ED).
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Nonfederal California hospitals (n = 284).
  
  
  METHODS
  Visits of Medicare beneficiaries aged 65 and older discharged from California EDs in 2007 (n = 505,315).
  
  
  METHODS
  Using the California Office of Statewide Health Planning and Development files, predictors of hospital inpatient admission within 7 days of ED discharge in older adults (≥65) with Medicare were evaluated.
  
  
  RESULTS
  Hospital inpatient admissions within 7 days of ED discharge occurred in 23,340 (4.6%) visits and were associated with older age (70-74: adjusted odds ratio (AOR) = 1.12, 95% confidence interval (CI) = 1.07-1.17; 75-79: AOR = 1.18, 95% CI = 1.13-1.23; ≥80: AOR = 1.4, 95% CI = 1.35-1.46), skilled nursing facility use (AOR = 1.82, 95% CI = 1.72-1.94), leaving the ED against medical advice (AOR = 1.82, 95% CI = 1.67-1.98), and the following diagnoses with the highest odds of admission: end-stage renal disease (AOR = 3.83, 95% CI = 2.42-6.08), chronic renal disease (AOR = 3.19, 95% CI = 2.26-4.49), and congestive heart failure (AOR = 3.01, 95% CI = 2.59-3.50).
  
  
  CONCLUSIONS
  Five percent of older Medicare beneficiaries have a hospital inpatient admission after discharge from the ED. Chronic conditions such as renal disease and heart failure were associated with the greatest odds of admission.
authors.affiliation: Department of Medicine, University of California at Los Angeles, Los Angeles, California; Department of Medicine, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California; Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon.
authors.forename: Gelareh Z
authors.initials: GZ
authors.lastname: Gabayan
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Sarkisian
authors.forename: Li-Jung
authors.initials: LJ
authors.lastname: Liang
authors.forename: Benjamin C
authors.initials: BC
authors.lastname: Sun
mesh_terms: D000368:Aged; D002140:California; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D006278:Medicare; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States
keywords: Medicare; emergency department; outcomes