Unmet Need for Help With Activities of Daily Living Disabilities and Emergency Department Admissions Among Older Medicare Recipients

Zach Hass, Glen DePalma, Bruce A. Craig, Huiping Xu, Laura P. Sands

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Purpose of the Study: This study determined whether self-reports of unmet need for help with activities of daily living (ADL) disabilities are prognostic of emergency department (ED) utilization.

Design and Methods: This prospective cohort study of 2,194 community-living, ADL-disabled subjects combined 2004 National Long-Term Care Survey responses with linked Medicare data through 2005. A negative binomial count model was computed to assess the association between unmet ADL need and number of subsequent ED admissions while statistically adjusting for predisposing, enabling, and need characteristics associated with ED admissions among older adults.

Results: The adjusted annual incidence rate (IR) for ED admissions was 19% higher for unmet versus met need (IR = 1.19; 95% confidence interval [CI] = 1.00-1.40; p = .047). The IR for ED admissions for falls and injuries was higher for those with unmet ADL versus met ADL need (IR = 1.43; 95% CI = 1.10-1.86), and trended toward significance for ED admissions for skin breakdown (IR = 2.02; 95% CI = 0.97-2.88), but was not significant for ED admissions for dehydration (IR = 1.13; 95% CI= 0.79-1.63).

Implications: Unmet ADL need is prognostic of ED admissions, especially for falls and injuries. Future research is needed to determine whether resolution of unmet ADL need reduces ED utilization.

Original languageEnglish (US)
Pages (from-to)206-210
Number of pages5
JournalThe Gerontologist
Volume57
Issue number2
DOIs
StatePublished - Apr 1 2017

Fingerprint

Activities of Daily Living
Medicare
Hospital Emergency Service
Incidence
Confidence Intervals
Wounds and Injuries
Long-Term Care
Statistical Models
Dehydration
Self Report
Cohort Studies
Prospective Studies
Skin

Keywords

  • Disabilities
  • Home and Community based care and services
  • Medicaid/Medicare

ASJC Scopus subject areas

  • Gerontology
  • Geriatrics and Gerontology

Cite this

Unmet Need for Help With Activities of Daily Living Disabilities and Emergency Department Admissions Among Older Medicare Recipients. / Hass, Zach; DePalma, Glen; Craig, Bruce A.; Xu, Huiping; Sands, Laura P.

In: The Gerontologist, Vol. 57, No. 2, 01.04.2017, p. 206-210.

Research output: Contribution to journalArticle

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