Half of older Americans seen in emergency department in last month of life; most admitted to hospital, and many die there.

TitleHalf of older Americans seen in emergency department in last month of life; most admitted to hospital, and many die there.
Publication TypeJournal Article
Year of Publication2012
AuthorsSmith, AK, McCarthy, E, Weber, E, Cenzer, IStijacic, W Boscardin, J, Fisher, J, Covinsky, KE
JournalHealth Aff (Millwood)
Volume31
Issue6
Pagination1277-85
Date Published2012 Jun
ISSN Number1544-5208
KeywordsAged, Aged, 80 and over, Emergency Service, Hospital, Female, Hospital Mortality, Hospitalization, Humans, Insurance Claim Review, Male, Terminal Care, Terminally Ill, United States
Abstract

Emergency department use contributes to high end-of-life costs and is potentially burdensome for patients and family members. We examined emergency department use in the last months of life for patients age sixty-five or older who died while enrolled in a longitudinal study of older adults in the period 1992-2006. We found that 51 percent of the 4,158 [corrected] decedents visited the emergency department in the last month of life, and 75 percent in the last six months of life. Repeat visits were common. A total of 77 percent of the patients seen in the emergency department in the last month of life were admitted to the hospital, and 68 percent of those who were admitted died there. In contrast, patients who enrolled in hospice at least one month before death rarely visited the emergency department in the last month of life. Policies that encourage the preparation of patients and families for death and early enrollment in hospice may prevent emergency department visits at the end of life.

URLhttp://content.healthaffairs.org/content/31/6/1277.full.html
DOI10.1377/hlthaff.2011.0922
User Guide Notes

http://www.ncbi.nlm.nih.gov/pubmed/22665840?dopt=Abstract

Endnote Keywords

elderly/Medicare/Primary Care/public policy/Health care policy/emergency department service use/emergency department service use

Endnote ID

69508

Alternate JournalHealth Aff (Millwood)
Citation Key7722
PubMed ID22665840
PubMed Central IDPMC3736978
Grant ListKL2 RR024130 / RR / NCRR NIH HHS / United States
UL1 RR024131 / RR / NCRR NIH HHS / United States
K24AG029812 / AG / NIA NIH HHS / United States
K23 AG040772 / AG / NIA NIH HHS / United States
K24 AG029812 / AG / NIA NIH HHS / United States