Emergency department admissions and economic costs burden related to ambulatory care sensitive conditions in older adults living in care homes
Afonso-Argilés, F. Javier (Universitat Autònoma de Barcelona)
Comas-Serrano, Mercè (Institut Hospital del Mar d'Investigacions Mèdiques)
Castells-Oliveres, Xavier (Institut Hospital del Mar d'Investigacions Mèdiques)
Cirera-Lorenzo, I. (Hospital del Mar (Barcelona, Catalunya))
García-Pérez, Dolors (Fundació Althaia)
Pujadas-Lafarga, Teresa (Servicio de Geriatría y Cuidados Paliativos. Badalona Serveis Assistencials)
Ichart-Tomás, Xavier (Hospital Universitari Arnau de Vilanova)
Puig Campmany, Mireia (Institut d'Investigació Biomèdica Sant Pau)
Vena-Martínez, Ana B. (Hospital Universitari Arnau de Vilanova)
Renom-Guiteras, Anna (Hospital del Mar (Barcelona, Catalunya))

Títol variant:	Admisiones en los servicios de urgencias y costes económicos relacionados con procesos susceptibles de atención ambulatoria en adultos mayores que viven en centros residenciales
Data:	2023
Resum:	Objectives: To assess the frequency of emergency department admissions (EDAs) for ambulatory care sensitive conditions (ACSC) and non-ACSC among older adults living in care homes (CH), to describe and compare their demographic and clinical characteristics, the outcomes of the hospitalization process and the associated costs. Method: This multicenter, retrospective and observational study evaluated 2444 EDAs of older adults ≥65 years old living in care homes in five emergency departments in Catalonia (Spain) by ACSC and non-ACSC, in 2017. Sociodemographic variables, prior functional and cognitive status, and information on diagnosis and hospitalization were collected. Additionally, the costs related with the EDAs were calculated, as well as a sensitivity analysis using different assumptions of decreased admissions due to ACSC. Results: A total of 2444 ED admissions were analyzed. The patients' mean (SD) age was 85. 9 (7. 2) years. The frequency of ACSC-EDA and non-ACSC-EDA was 56. 6% and 43. 4%, respectively. Severe dependency and cognitive impairment were present in 56. 6% and 78%, respectively, with no differences between the two groups. The three most frequent ACSC were falls/trauma (13. 8%), chronic obstructive pulmonary disease/asthma (11. 4%) and urinary tract infection (7. 4%). The average cost per ACSC-EDA was €1408. 24. Assuming a 60% reduction of ACSC-EDA, the estimated cost savings would be €1. 2 million. Conclusions: Emergency admissions for ACSC from care homes have a significant impact on both frequency and costs. Reducing these conditions through targeted interventions could redirect the avoided costs toward improving care support in residential settings.
Nota:	Este trabajo se llevó a cabo dentro del programa de doctorado en Metodología de Investigación Biomédica y Salud Pública de la Universitat Autònoma de Barcelona.
Drets:	Tots els drets reservats.
Llengua:	Castellà
Document:	Article ; recerca ; Versió acceptada per publicar
Matèria:	Ambulatory care sensitive conditions ; Hospitalización ; Residència ; Ancianos ; Hospitalisation ; Care home ; Aged
Publicat a:	Revista Clinica Espanola, Vol. 223 Núm. 10 (diciembre 2023) , p. 585-595, ISSN 1578-1860

DOI: 10.1016/j.rce.2023.09.004

37 p, 1.2 MB

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