The aim of this systematic review is to estimate the incidence and prevalence of ED visits in NHRs, focusing on age-specific and sex-specific patterns. On the other hand, previous research showed that male NHRs are more often hospitalised than female NHRs, which might also apply for ED visits. This seems also to be the case for ED visits with studies showing different findings. Overall, the literature on age differences in hospitalisations of NHRs is inconclusive. compared ED use by older adults to younger age groups, but they did not report on further age differences in NHRs. In their systematic review published in 2011, Gruneir et al. Patterns of chronic diseases differ between sexes and across the age span in this population, but most studies present epidemiologic measures aggregated for both sexes and potential differences between age groups are often not further examined. Īlthough NHRs are typically older than 65 years, they represent a wide range of age groups up to over 100 years and a large proportion is female with increasing tendency in older age groups. Approximately 50% of NHRs visiting EDs are discharged back to the nursing home without being hospitalised and almost one fifth of presentations followed by ED discharge had no diagnostic testing at all. Furthermore, it is questionable if benefits outweigh potential risks as ED visits of NHRs often result in unintended consequences and adverse outcomes like greater cognitive and physical decline or hospital-acquired infections. However, a large proportion of these ED presentations is considered inappropriate. Compared with community dwellers nursing home residents (NHRs) have higher utilisation rates of EDs. In 2014, just over 1.4 million residents were living in US nursing homes, corresponding to 2.6% of the over-65 population and 9.5% of the over-85 population. In times of demographic changes, the burden on ED systems may further increase.

Older people use emergency department (ED) services more often than persons of younger age. These studies should include large sample sizes to provide a more differentiated age categorisation. Any future study on acute care of NHRs should assess the influence of age and sex. Male NHRs visit EDs more often than females, but there is no evidence on reasons. Only one study reported main diagnoses leading to ED visits stratified by sex. There was no study reporting stratified analyses by age and sex. Hospital admission rate ranged from 36.4 to 48.7%. Studies used 85+ or 86+ years as the highest age category. There was no clear pattern with some studies showing no association between ED visits and age and other studies reporting decreasing ED visits with increasing age or increasing proportions followed by a decrease in the highest age group. All studies assessed the influence of age. All but one of the five studies with multivariable analyses reported a statistically significant positive association (with odds or rate ratios of 1.05–1.38). Most studies assessing the influence of sex found that male residents visited EDs more frequently. Overall, 29–62% of NHRs had at least one ED visit over the course of 1 year.

Six studies were conducted in the USA or Canada. Out of 1192 references, we found seven studies meeting our inclusion criteria. The quality of studies was assessed by the Joanna Briggs Institute critical appraisal tool for prevalence studies. Two reviewers independently identified articles for inclusion. Articles published on or before were eligible. MethodsĪ systematic review was carried out based on articles found in MEDLINE (via PubMed), CINAHL and Scopus. We aimed to study the epidemiology of ED visits in NHRs focusing on age- and sex-specific differences. It is unclear, which influence age has on ED visits. There is evidence that male NHRs are more often hospitalised, but this is less clear for ED visits. A great proportion of ED visits is considered inappropriate.

Nursing home residents (NHRs) are often transferred to emergency departments (EDs).

Ed visits