Frequency and predictors of emergency department visits among the oldest old in Finland: the Vitality 90+ Study
Abstract Background Emergency department (ED) visits increase with age. However, knowledge about the frequency and drivers of ED visits among the oldest old (90 years and above) is scarce, and neither is it known whether patterns differ between those living at home and in round-the-clock care. As un...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-06-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-025-12923-2 |
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| Summary: | Abstract Background Emergency department (ED) visits increase with age. However, knowledge about the frequency and drivers of ED visits among the oldest old (90 years and above) is scarce, and neither is it known whether patterns differ between those living at home and in round-the-clock care. As understanding of ED use and the factors influencing ED visits is crucial for the functioning of health care systems, this study examined the frequency and predictors of ED visits in a 90+ population living at home and in round-the-clock care. Methods Data from the Vitality 90+ survey, a population-based study with 1561 respondents in 2014 in Tampere, Finland, was combined with national register data on ED use and mortality until the end of 2017. Predictors of the first ED visit were examined using Cox regression models (4-year cumulative hazard) and the frequency and predictors of 1–3 and ≥ 4 ED visits in one year of follow-up with multinomial logistic regression models. Results Over the four-year study period, 79% of the participants had at least one ED visit. Those living at home had higher cumulative hazards of ED visits and were more often frequent ED users (≥ 4 ED visits) than those living in round-the-clock care. Not receiving home care, multimorbidity, poor subjective health and wellbeing, and limitations in functioning increased the risk of ED visits among home dwellers, while having dementia, limitations in functioning, impaired sensory functions, and less frequent social contacts decreased the risk among round-the-clock care residents. In both groups, the predictors of ED visits were similar in one- and four-year follow-ups. Conclusions The frequency and predictors of ED visits greatly differ between those living at home and in round-the-clock care. Since most ED visits occurred among those living at home and having poor health but not receiving formal home care, improving the continuity of care and the coverage of home care services could help to curb the increase in ED visits among the fast-growing oldest old population. |
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| ISSN: | 1472-6963 |