Functional Decline Predicts Emergency Department Use in Veterans With Dementia
Stephanie Ng, Robert O Morgan, Annette Walder, Jonmenjoy Biswas, David M Bass, Katherine S Judge, A Lynn Snow, Nancy Wilson, Mark E Kunik, Stephanie Ng, Robert O Morgan, Annette Walder, Jonmenjoy Biswas, David M Bass, Katherine S Judge, A Lynn Snow, Nancy Wilson, Mark E Kunik
Abstract
Background: We examined emergency room (ER) utilization by persons with dementia (PWDs) using caregiver and patient characteristics as predictors.
Methods: A secondary analysis of 296 veteran-caregiver dyads. Caregivers recorded PWD baseline characteristics and noted ER visits over the next year. Two sets of regression models analyzed categorical ER use and repeat ER use.
Results: In the univariate analysis, categorical use of the ER was predicted by patients' functional status (P ≤ .008) and Veterans Affairs priority grouping (P ≤ .02). Repeat ER admissions were predicted by functional status (P ≤ .04), number of chronic conditions (P ≤ .01), and caregiver-reported relationship strain (P ≤ .04). In multivariate analysis, categorical ER use was predicted by functional status (P ≤ .02), priority grouping (P ≤ .03), and number of chronic conditions (P ≤ .06).
Conclusions: Functional status most strongly predicted ER use, highlighting the promise of home-based interventions to improve activities of daily living. Number of chronic conditions and caregiver-reported relationship strain are potential targets of intervention during discharge process.
Keywords: activities of daily living; dementia; emergency; health services research; medical services.
© The Author(s) 2014.
Source: PubMed