• Maryann Street, Jonathon R Marriott, and Patricia M Livingston.
• School of Nursing & Midwifery, Deakin University, Burwood, Victoria 3125, Australia. maryann.street@deakin.edu.au
• Australas Emerg Nurs J. 2012 Nov 1;15(4):211-8.

BackgroundThere is limited research on the effect of emergency access targets on health outcomes for older patients from Residential Aged Care Facilities. The aims were to: (1) identify length of stay for Residential Aged Care patients relative to access targets; and (2) examine hospital admission rates, readmission rates, inpatient costs and mortality.MethodsRetrospective cohort study of all emergency presentations for Residential Aged Care patients in 2009 at one Australian metropolitan health service.ResultsThe 4637 emergency presentations by 3184 Residential Aged Care patients in 2009 represented 3.4% of all emergency presentations. Mean length of stay was 7.9 hours (SD=4.5 hours); 84% of Residential Aged Care patients remained in the Emergency Department longer than four hours. Admitted patients were 3.6 times more likely to spend more than eight hours in the Emergency Department compared with those not admitted (p<0.001). Patients in the urgent triage category were 9.5 times more likely to spend more than eight hours in the Emergency Department compared to patients triaged as non-urgent (p<0.001). Inpatient costs were associated with length of admission and median cost per day was $AUD 1175.ConclusionFew Residential Aged Care patients were discharged within the four hours access target. This has implications for health care outcomes and costs associated with providing emergency care for patients living in Residential Aged Care Facilities.Copyright © 2012 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.

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