• G Arendts, C Dickson, K Howard, and S Quine.
• Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia. glenn.arendts@uwa.edu.au
• Intern Med J. 2012 Jan 1;42(1):75-82.

BackgroundIn order to design optimal systems to meet the acute healthcare needs of the frail elderly living in residential care, good clinical information is essential. The aims of this study were to analyse the casemix and outcomes of patients transferred from residential aged care facilities to public hospital emergency departments in New South Wales.MethodsIndividual patient data from six hospital emergency departments and inpatient wards were obtained from merged databases and analysed using descriptive and comparative statistics.ResultsOutcomes in 4680 patient transfers over a 12-month period in 2006-2007 were analysed. Transfers occur mostly in high-acuity patients, with approximately three of every four transfers admitted; one in every 12 dying; and admitted patients undergoing an average of 2.4 interventions or procedures during each hospital stay. Several variables are associated with prolonged length of emergency department stay including triage urgency, type of hospital and transfers occurring in winter or out of hours.ConclusionsPatients transferred from aged care facilities to emergency departments are predominantly high-acuity patients with a substantial likelihood of hospitalisation, intervention and death. Nevertheless, scope exists for some episodes of acute care, in both discharged and admitted patients, to be provided outside a hospital setting.© 2010 The Authors. Internal Medicine Journal © 2010 Royal Australasian College of Physicians.

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