title: Emergency department utilisation among older people with acute and/or chronic conditions: A multi-centre retrospective study.
abstract: Older persons aged over 65years represent up to 41% of Australian Emergency Department (ED) presentations. Older persons present with acute and/or chronic conditions, have more Emergency Department visits, hospital admissions and readmissions than other age groups. However, little is known about the characteristics and trends of acute illness and chronic presentations and whether frailty changes these dimensions within this cohort.
  
  
  
  A 12-month retrospective medical record audit of persons over 65years presenting to four EDs.
  
  
  
  Data from 44,774 (26.6%) patients aged 65years and over were analysed. Patients with acute conditions presented more frequently (n=30,373; 67.8%), received more urgent triage categories (n=13,471; 30.1%) and had higher admission rates (n=18,332; 61%). Chronic conditions presented less frequently (n=14,396; 32.1%) and had higher discharge rates (n=9302; 65%). Patients over 80years were allocated more urgent triage categories and commonly presented with falls (n=3814; 8.5%). Patients between 65 and79years had a higher discharge rate (n=10,397; 46.1%).
  
  
  
  Older persons with acute illnesses were more likely to be admitted than those with chronic conditions and who were more likely to be discharged home. There is scope for further investigation of new models of care to better manage older persons with chronic conditions and ED discharge practices.
authors.affiliation: Northern Sydney Local Health District, Faculty of Health, University of Technology Sydney, Australia. Electronic address: Margaret.Fry@uts.edu.au.
authors.forename: Margaret
authors.initials: M
authors.lastname: Fry
authors.affiliation: Emergency Department, Royal North Shore Hospital, Northern Sydney Local Health District, Honorary Associate, Faculty of Health, University of Technology Sydney, Australia. Electronic address: lesley.mullen@health.nsw.gov.au.
authors.forename: Lesley
authors.initials: L
authors.lastname: Fitzpatrick
authors.affiliation: Deakin University, School of Nursing, Geelong, Victoria, Australia; Centre for Quality and Patient Safety Research, 221 Burwood Highway, Burwood, Victoria 3125, Australia; Eastern Health - Deakin University Nursing & Midwifery Research Centre, Level 2, 5 Arnold St, Box Hill, Victoria 3138, Australia. Electronic address: julie.considine@deakin.edu.au.
authors.forename: Julie
authors.initials: J
authors.lastname: Considine
authors.affiliation: Menzies Health Institute Queensland, School of Nursing and Midwifery Griffith University, Nathan Campus, N48 Health Sciences Building, 170 Kessels Rd, Nathan, Qld 4111, Australia; Department of Infection Control and Infectious Diseases, Gold Coast University Hospital, Gold Coast Hospital and Health Service, 1 Hospital Blvd, Southport, Qld 4215, Australia. Electronic address: r.shaban@griffith.edu.au.
authors.forename: Ramon Z
authors.initials: RZ
authors.lastname: Shaban
authors.affiliation: Sydney Nursing School, University of Sydney, 88 Mallet St, Camperdown, NSW, Australia; Trauma Service, St George Hospital, Gray St, Kogarah, NSW, Australia; St George Clinical School, Faculty of Medicine, University of NSW, NSW, Australia. Electronic address: kate.curtis@sydney.edu.au.
authors.forename: Kate
authors.initials: K
authors.lastname: Curtis
mesh_terms: D000208:Acute Disease / Q000453:epidemiology*; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000453:epidemiology*; D015331:Cohort Studies; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D009517:New South Wales / Q000453:epidemiology; D012189:Retrospective Studies
keywords: Chronic illness; Emergency Department; Falls; Geriatrics; Older person; Pain