P56 | Analysis of emergency department use by frailty patients coming from long-term care facilities: impact on the medicine department
D. Dalla Gasperina1, E. Morosi2, M. Lanciani2, G. Cappellari2, A. Galantino2, W. Ageno3, F. Dentali3 | 1Dipartimento di Medicina e Innovazione Tecnologica, Università dell’Insubria, ASST Sette Laghi, Varese, 2ASST Sette Laghi, Varese, 3Dipartimento di Medicina e Chirurgia, Università dell’Insubria, ASST Sette Laghi, Varese, Italy
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Premises and Purpose of the study: Long-Term care facilities (LTCFs) residents who transfer to Emergency Departments (ED) have been identified as problematic because they use considerable resources. Our study aimed to describe the motivation for ED use by frailty patients coming from LTCFs.
Materials and Methods: A single-center retrospective observational study was conducted in a tertiary care hospital. All frailty LTCF residents admitted to 5 ED of ASST Sette Laghi, Varese, were enrolled between March and May 2023.
Results: 385 patients (239 F, median age 84.9 [range 43-101] yrs) were enrolled. The average length of stay (LOS) in ED was 19.2 hrs. Primary causes of ED use were infectious diseases (ID) (38.5%), trauma (22.6%), cardiovascular diseases (11.4%), neurological diseases (4.9%), anemia (4.9%), device complications (PEG tube dislodgment and indwelling urinary catheter obstruction) (3.6%). Pneumonia and urinary tract infections were the most frequent ID. Most patients (60%) were discharged to LTCF, 143 (37.2%) were hospitalized (81.1% of these in the Medicine Department), and 11 (2.8%) died in the ED. The average LOS in the hospital was 13.3 days (range 0-74). The patients with ID were admitted to hospital more frequently (58.1% vs. 24%, p<0.0001), with longer LOS in ED (21.6 vs. 16.8 hrs, p=0.0001) and in the hospital (15.2% vs. 10.4%, p=0.01).
Conclusions: Access to the ED and hospitalization of LTCF patients significantly impact the Medicine Department. Managing the most frequent pathologies, such as infections, at the LTCFs would substantially reduce costs.
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