Emergency rooms see too many elderly nursing home residents, researchers say

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A disproportionately high number of nursing home residents are being admitted to hospital emergency departments, and many of these admissions are potentially avoidable, according to recently published research.

Researchers from the University of California-San Francisco looked at 2001-2010 data from the National Hospital Ambulatory Medical Care Survey. The rate of emergency room admissions for elderly nursing home residents increased nearly 13% during that time frame, they found. The total number of ED admissions for this population reached 2.1 million in 2010.

Pneumonia was the most common cause of these admissions, followed by urinary tract infections, the researchers discovered.

The researchers had hypothesized that the rate of ED admissions would have declined, due to the government's increasing focus on the quality of long-term care. Transfers to emergency rooms can erode care quality by causing trauma for residents, the authors noted. 

Increased care coordination and other measures, such as financial penalties tied to readmissions, could reverse the trend, according to the research team. They wrote that the "ambulatory-care sensitive conditions" associated with the emergency room visits likely could be managed in some cases by skilled nursing facility teams, if the proper incentives to do so are in place.

The findings appear in JAMA Internal Medicine.