• Gelareh Z Gabayan, Catherine A Sarkisian, Li-Jung Liang, and Benjamin C Sun.
• 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.
• J Am Geriatr Soc. 2015 Jan 1;63(1):39-45.

ObjectivesTo identify predictors of hospital inpatient admission of older Medicare beneficiaries after discharge from the emergency department (ED).DesignRetrospective cohort study.SettingNonfederal California hospitals (n = 284).ParticipantsVisits of Medicare beneficiaries aged 65 and older discharged from California EDs in 2007 (n = 505,315).MeasurementsUsing 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.ResultsHospital 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).ConclusionFive 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.© 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

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