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Primary diagnoses and outcomes of emergency department visits in older people with dementia: a hospital-based retrospective study in Taiwan

Published online by Cambridge University Press:  29 April 2019

Pei-Chao Lin ,
Li-Chan Lin ,
Hsiu-Fen Hsieh ,
Yao-Mei Chen ,
Pi-Ling Chou  and
Chien-Hsun Li
Pei-Chao Lin
Affiliation:
School of Nursing, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
Li-Chan Lin
Affiliation:
Institute of Clinical Nursing, National Yang-Ming University, Taipei, Taiwan
Hsiu-Fen Hsieh
Affiliation:
School of Nursing, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
Yao-Mei Chen
Affiliation:
School of Nursing, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan International Medical Service Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
Pi-Ling Chou
Affiliation:
School of Nursing, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
Chien-Hsun Li*
Affiliation:
Department of Neurology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
*
Correspondence should be addressed to: Chien-Hsun Li, Attending physician, MD, Department of Neurology, Kaohsiung Municipal Siaogang Hospital, No. 482, Shanming Road, Siaogang Dist., Kaohsiung 812, Taiwan. Phone: +886 7 803-6783 ext. 3453. Email: gavli@kmu.edu.tw.
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Abstract

Objectives:

The objectives of this study were to investigate the primary diagnoses and outcomes of emergency department visits in older people with dementia and to compare these parameters with those in older adults without dementia.

Design and Setting:

This hospital-based retrospective study retrieved patient records from a hospital research database, which included the outpatient and inpatient claims of two hospitals.

Participants:

The patient records were retrieved from the two hospitals in an urban setting. The inclusion criteria were all patients aged 65 and older who had attended the two hospitals as an outpatient or inpatient between January 1, 2009, and December 31, 2016. Patients with dementia were identified to have at least three reports of diagnostic codes, either during outpatient visits, during emergency department visits, or in hospitalized database records. The other patients were categorized as patients without dementia.

Measurements:

The primary diagnosis during the emergency department visit, cost of emergency department treatment, cost of hospital admission, length of hospital stay, and diagnosis of death were collected.

Results:

A total of 149,203 outpatients and inpatients aged 65 and older who were admitted to the two hospitals were retrieved. The rate of emergency department visits in patients with dementia (23.2%) was lower than that in those without dementia (48.6%). The most frequent primary reason for emergency department visits and the main cause of patient death was pneumonia. Patients with dementia in the emergency department had higher hospital admission rates and longer hospital stays; however, the cost of treatment did not show a significant difference between the two groups.

Conclusions:

Future large and prospective studies should explore the severity of disease in older people with dementia and compare results with older adults without dementia in the emergency department.

Keywords

dementiaemergency departmenthospitalpneumonia
Type
Original Research Article
Information
International Psychogeriatrics , Volume 32 , Issue 1: Issue Theme: Cultural Diversity in Psychogeriatrics , January 2020 , pp. 97 - 104
Copyright
© International Psychogeriatric Association 2019 

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