ED Visits By Nursing Home Residents 'Disproportionately High'
An emergency medicine physician and researcher suggests that skilled nursing facility residents with "ambulatory care-sensitive conditions" may be treated appropriately in healthcare settings other than the emergency department.
"Going to the emergency department can actually be somewhat traumatic" for a nursing home patient, says Renee Hsia, MD, an emergency department physician at the University of California San Francisco Department of Emergency Medicine.
Yet nearly one in five patients taken to a hospital emergency department from a skilled nursing facility are treated for so-called "ambulatory care-sensitive conditions," suggesting that some of their medical issues might be more effectively managed by the SNF's healthcare team, or in another less intense setting.
Hsia and colleagues from the UCSF Department of Emergency Medicine, analyzed annual National Hospital Ambulatory Medical Care Survey data from 2001 to 2010 whose Research Letter published Monday in JAMA Internal Medicine.
She describes what it's like for these sick, elderly patients. "They're waiting a long time, sometimes in the hallway with a lot of commotion, and it's definitely not a comfortable environment. And these are patients who are going to be sensitive to different environment, in terms of delirium."
If a visit to the ED can be avoided, she says, it should be.