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Emergency Department Visit Rates and Patterns in Canada’s Vancouver Coastal Health Region*

Published online by Cambridge University Press:  01 April 2014

Margaret J. McGregor*
Affiliation:
Department of Family Practice, University of British Columbia, Vancouver, Canada Vancouver Coastal Health Research Institute, Centre for Clinical Epidemiology & Evaluation, Vancouver UBC Centre for Health Services and Policy Research, Vancouver
Kimberlyn M. McGrail
Affiliation:
UBC Centre for Health Services and Policy Research, Vancouver UBC School of Population and Public Health, Vancouver
Riyad B. Abu-Laban
Affiliation:
Vancouver Coastal Health Research Institute, Centre for Clinical Epidemiology & Evaluation, Vancouver UBC Department of Emergency Medicine, Vancouver
Lisa A. Ronald
Affiliation:
Vancouver Coastal Health Research Institute, Centre for Clinical Epidemiology & Evaluation, Vancouver
Jennifer Baumbusch
Affiliation:
UBC School of Nursing, Vancouver
Douglas Andrusiek
Affiliation:
Emergency and Health Services Commission, Vancouver
Michelle B. Cox
Affiliation:
Vancouver Coastal Health Research Institute, Centre for Clinical Epidemiology & Evaluation, Vancouver
*
La correspondance et les demandes de tirés-à-part doivent être adressées à: / Correspondence and requests for offprints should be sent to: Margaret J. McGregor, M.D., M.H.Sc. University of British Columbia Department of Family Practice Room 713, 828 West 10th Avenue Vancouver, BC V5Z 1L8 (mrgret@mail.ubc.ca)

Abstract

This study used administrative health data to describe emergency department (ED) visits by residents from assisted living and nursing home facilities in the Vancouver Coastal Health region, British Columbia. We compared ED visit rates, the distribution of visits per resident, and ED dispositions of the assisted living and nursing home populations over a 3-year period (2005–2008). There were 13,051 individuals in our study population. Visit rates (95% confidence interval) were 124.8 (118.1–131.7) and 64.1 (62.9–65.3) visits per 100 resident years in assisted living and nursing home facilities respectively. A smaller proportion of ED visits by assisted living residents resulted in hospital admission compared to nursing home residents (45% vs. 48%, p < .01). The ED visit rate among assisted living residents is significantly higher compared to that among nursing home residents. Future research is needed into the underlying causes for this finding.

Résumé

Cette étude a utilisé des données sur la santé administratives pour décrire des visites effectuées par les résidents de vie assistée et ceux des foyers de soins infirmiers à domicile au service d’urgence (SU) dans la région de Vancouver Coastal Health, Colombie-Britannique. Nous avons comparé taux de visite SU, la répartition des visites par résident, et les dispositions SU des deux populations—d’aide à la vie autonome ou du foyer de soins infirmiers pendant une période de 3 ans (2005-2008). Il y avait 13 051 personnes dans la population étudiée. Taux de visite (intervalle de confiance de 95 pourcent) étaient de 124,8 (118,1 à 131,7) et 64,1 (62,9 à 65,3) visites par 100 ans résidants dans les logements avec assistance et les foyers de soins infirmier à domicile, respectivement. Une plus faible proportion de visites à l’urgence par les résidents de vie assistée ont entraîné une hospitalisation par rapport aux résidents des foyers de soins (45% vs 48%, p<0,01). Le taux de visite à l’urgence chez les résidents de vie assistée est significativement plus élevée par rapport à celle des résidents des foyers de soins. De nouvelles recherches s’imposent sur les causes sous-jacentes de cette constation.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2014 

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Footnotes

*

This study was supported by an operating grant from the Vancouver Foundation (2008–2011), the University of British Columbia’s Department of Family Practice Community Geriatrics and Vancouver General Hospital’s Department of Family Practice. Margaret McGregor was supported by a Vancouver Foundation Community-Based Clinician Investigator Award (2007–2011). We gratefully acknowledge the following individuals: Penny Brasher, VCHRI’s Centre for Clinical Epidemiology and Evaluation, who contributed to the original data extraction and management; Lisa Kuramoto, VCHRI’s Centre for Clinical Epidemiology and Evaluation, and Michael Schulzer, UBC Department of Statistics, who contributed to the data management and analytic approach; Kia Salomons, research assistant who coordinated the data extraction; Susan Sirrett, Patricia Chung, and Colin Sue (VCH Decision Support), Carole Astley and Catherine Barnardo (Fraser Health Decision Support), and Karl Newholm and Areta Wong (Providence Health Care Decision Support), all of whom assisted in data extraction from their respective administrative databases; and the librarians of the BC College of Physicians and Surgeons Library who assisted with literature searches.

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