INTRODUCTION. Half of elderly patient hospitalizations are preceded by an emergency department (ED) visit, and a higher proportion is observed among those living in institutions. These patients are more often exposed to problems related to hospital occupancy and overcrowding, which may lead to hospitalization in inappropriate wards (IWs) and increased morbidity and health care costs. At the same time, elderly individuals living in institutions, due to their high vulnerability, are the most exposed to these negative health care outcomes and might have priority in geriatric beds. The aim of this study was to explore whether living conditions were associated with admission to an IW after visiting an ED.
METHOD. The French Emergency Survey was a one-day, nationwide, cross-sectional survey in 2013 in all EDs in France. We focused on patients ≥ 75 years old who had been hospitalized. Descriptive analysis and multilevel logistic regression were used.
RESULTS. Among the 3,285 patients, 16.5% were admitted to an IW: 15.7% among those living in institutions and 16.6% among those living at home. ED visits during peak periods and reaching the ED by her/his own means were the only factors associated with an increased likelihood of admission to an IW. There was no association with living conditions.
CONCLUSION. Living conditions were not observed to be associated with the likelihood of being hospitalized in an IW after an ED visit. Given the limited bed resources and the greater vulnerability of elderly individuals living in institutions (compared with those living at home), progress can be made in the coordination of acute geriatric care.