TABLE 1. Characteristics of Emergency Department Visits by US Nursing Home Residents, 2005-2008.
Odds ratios for nursing home vs. non-nursing home, unadjusted and adjusted for age-decile, sex, and race and ethnicity category.
| Characteristic | Nursing Home Residents (n=2,276,184 annual ED visits) |
Non-Nursing Home Residents (n=116,493,273 annual ED visits) |
Odds Ratio Nursing Home vs. Non-Nursing Home |
Odds Ratio Nursing Home vs. Non-Nursing Home Adjusted for Age-Decile, Sex, Race/Ethnicity |
||||
|---|---|---|---|---|---|---|---|---|
| % | (95% CI) | % | (95% CI) | OR | (95% CI) | OR | (95% CI) | |
| Age (mean, 95% CI) | 76.7 | (75.8-77.5) | 35.9 | (35.2-36.3) | *†40.8 | (39.8-41.8) | †N/A | |
| Sex | ||||||||
| Female | 63.3 | (60.9-65.6) | 54.0 | (53.5-54.5) | Ref | --- | †N/A | |
| Male | 36.7 | (34.4-39.1) | 46.0 | (45.5-46.5) | 0.7 | (0.6-0.8) | ||
| Race and Ethnicity | ||||||||
| Non-Hispanic White | 74.8 | (71.5-77.9) | 61.0 | (58.4-63.5) | Ref | --- | †N/A | |
| Non-Hispanic Black | 16.4 | (13.7-19.4) | 22.2 | (19.7-24.9) | 0.6 | (0.5-0.7) | ||
| Hispanic | 6.2 | (4.4-8.7) | 13.2 | (11.4-15.2) | 0.4 | (0.3-0.5) | ||
| Asian, Hawaiian, Pacific Islander, American Indian, Alaskan, Multiple Races |
2.6 | (1.8-3.8) | 3.7 | (3.1-4.3) | 0.6 | (0.4-0.8) | ||
| Hospital Geographic Region | ||||||||
| Northeast | 23.5 | (19.6-27.8) | 18.8 | (16.7-21.2) | ‡1.7 | (1.3-2.2) | ‡1.7 | (1.3-2.1) |
| Midwest | 25.1 | (20.7-30.1) | 22.4 | (18.7-26.6) | ‡1.5 | (1.2-1.9) | ‡1.6 | (1.3-2.0) |
| South | 37.9 | (33.0-43.1) | 40.3 | (36.2-44.7) | ‡1.3 | (1.0-1.6) | ‡1.6 | (1.3-2.0) |
| West | 13.6 | (11.0-16.6) | 18.4 | (14.8-22.7) | Ref | --- | Ref | --- |
| Hospital Metropolitan Location | ||||||||
| MSA | 80.8 | (69.6-88.6) | 84.7 | (75.7-90.8) | Ref | --- | Ref | --- |
| Non-MSA | 19.2 | (11.4-30.4) | 15.3 | (9.2-24.3) | ‡1.3 | (1.1-1.6) | 1.1 | (0.9-1.3) |
| Mode of Arrival | ||||||||
| Walk-In | 12.9 | (11.2-14.8) | 78.8 | (77.7-79.9) | Ref | --- | Ref | --- |
| Public Service | 3.1 | (2.2-4.4) | 1.7 | (1.4-2.0) | ‡11.4 | (8.0-16.2) | ‡12.6 | (8.8-17.9) |
| Ambulance | 80.3 | (77.6-82.7) | 14.3 | (13.5-15.1) | ‡34.4 | (29.3-40.2) | ‡13.6 | (11.6-16.0) |
| Unknown | 3.7 | (2.6-5.2) | 5.2 | (4.6-5.9) | ‡4.4 | (3.1-6.1) | ‡3.4 | (2.5-4.6) |
| Time of Arrival | ||||||||
| 7a-3p | 44.4 | (41.1-47.8) | 39.7 | (39.1-40.2) | Ref | --- | Ref | --- |
| 3p-11p | 39.8 | (36.3-43.4) | 44.5 | (43.8-45.2) | ‡0.8 | (0.7-0.9) | 1.0 | (0.9-1.3) |
| 11p-7a | 15.8 | (13.2-18.7) | 15.9 | (15.3-16.4) | 0.9 | (0.7-1.1) | 1.3 | (0.981.0-1.6) |
|
Seen at Emergency Department
Within Prior 72 Hours |
||||||||
| No | 82.5 | (79.7-84.9) | 80.4 | (77.4-83.0) | Ref | --- | Ref | --- |
| Yes | 3.0 | (2.3-3.8) | 3.6 | (3.4-3.8) | 0.8 | (0.6-1.0)5) | 1.0 | (0.7-1.3) |
| Unknown | 14.6 | (12.2-17.3) | 16.0 | (13.4-19.1) | 0.9 | (0.7-1.1) | 0.9 | (0.8-1.1) |
|
Discharged from Hospital
Within Prior 7 Days |
||||||||
| No | 60.8 | (56.1-65.4) | 63.2 | (59.7-66.6) | Ref | --- | Ref | --- |
| Yes | 4.0 | (3.2-5.1) | 2.1 | (1.9-2.3) | ‡2.0 | (1.5-2.6) | ‡1.4 | (1.1-1.9) |
| Unknown | 35.1 | (30.6-39.9) | 34.7 | (31.3-38.2) | 1.1 | (0.9-1.2) | 1.0 | (0.9-1.1) |
|
Fever on ED Triage (Temperature <96.8 or ≥100.4°F) |
||||||||
| No | 92.9 | (91.4-94.2) | 94.4 | (94.1-94.7) | Ref | --- | Ref | --- |
| Yes | 7.1 | (5.8-8.6) | 5.6 | (5.3-5.9) | ‡1.3 | (1.04-1.6) | ‡1.9 | (1.5-2.4) |
|
Hypotension on ED Triage
(Systolic Blood Pressure <90 mmHg) |
||||||||
| No | 92.0 | (90.7-93.2) | 91.1 | (90.3-92.0) | Ref | --- | Ref | --- |
| Yes | 8.0 | (6.8-9.3) | 8.9 | (8.0-9.7) | 0.9 | (0.7-1.1) | ‡1.8 | (1.5-2.2) |
Ref = referent category. ED = Emergency Department. MSA = metropolitan statistical area. OR = Odds Ratio. CI = Confidence Interval.
*
Mean difference and 95% confidence interval.
†
Odds ratios for age, sex, race and ethnicity not adjusted.
‡
Significant at p<0.05.