TABLE 3. Diagnoses 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) | |
| 001-139.9 Infectious and Parasitic Diseases | 3.6 | (2.6-4.6) | 4.4 | (4.2-4.7) | 0.8 | (0.6-1.1) | ‡1.7 | (1.2-2.3) |
| 140-239.9 Neoplasms | 1.4 | (0.98-2.10) | 0.6 | (0.5-0.7) | ‡2.5 | (1.6-3.8) | 1.2 | (0.7-1.8) |
|
240-279.9 Endocrine, Nutritional and Metabolic Diseases, and Immunity Disorders |
13.2 | (11.78-14.87) | 4.4 | (4.2-4.6) | ‡3.3 | (2.9-3.7) | ‡1.6 | (1.4-1.8) |
| 250-250.9, 251.0-251.2 Diabetic, Hyperglycemic and Hypoglycemic Conditions |
4.1 | (3..02-5.24) | 1.6 | (1.5-1.7) | ‡2.6 | (2.0-3.5) | ‡1.5 | (1.1-2.0) |
|
280-289.9 Diseases of the Blood and Blood-
Forming Organs |
3.8 | (2.9-4.6)(3.0-4.7) | 1.2 | (1.1-1.3) | ‡3.2 | (2.4-4.1) | ‡1.4 | (1.1-1.8) |
| 290-319.9 Mental Disorders | 9.8 | (8..43-11.45) | 5.5 | (5.2-5.8) | ‡1.9 | (1.6-2.2) | ‡2.6 | (2.1-3.2) |
| 320-359.9 Diseases of the Nervous System | 3.8 | (2.8-4.8)(2.9-5.0) | 3.4 | (3.1-3.6) | 1.1 | (0.9-1.5) | ‡1.4 | (1.1-2.0) |
| 345-345.91, 649.40-649.44, 779.0, 780.3- 780.39 - Epilepsy, Seizures and Convulsions |
1.3 | (0.98-2.01.9) | 1.1 | (0.991.0-1.21) | 1.3 | (0.8-1.9) | ‡2.3 | (1.5-3.6) |
| 360-389.9 Diseases of the Sense Organs (-e.g, Eyes, Ears) | **0.6 | (0.3-0.910) | 4.4 | (4.2-4.7) | **0.1N/A | (0.1-0.2) | **0.4N/A | (0.2-0.6) |
| 390-459.9 Diseases of the Circulatory System | 20.9 | (18.54-23.64) | 6.6 | (6.2-7.0) | ‡3.7 | (3.2-4.4) | 1.1 | (0.9-1.2) |
| 410-414.9 Acute Myocardial Infarction and Ischemic Heart Disease |
2.7 | (1.7-3.69-3.8) | 1.2 | (1.0-1.3) | ‡2.3 | (1.6-3.4) | 0.7 | (0.5-1.1) |
| 426-427.9 - Dysrhythmias | 4.2 | (3.32-5.21) | 0.95 | (0.879-1.04) | ‡4.6 | (3.6-5.8) | 1.2 | (0.9-1.5) |
| 425, 425.1-425.2, 425.4-425.9, 428-428.9 Acute Heart Failure and Cardiomyopathies | 5.4 | (4.2-6.63-6.8) | 0.94 | (0.879-1.03) | ‡6.0 | (4.7-7.6) | 1.2 | (0.98(1.0-1.5) |
| 430-437.9 Hemorrhagic and Thrombotic Stroke |
3.0 | (2.3-4.02-3.9) | 0.7 | (0.6-0.8) | ‡4.5 | (3.3-6.1) | 1.1 | (0.8-1.5) |
| 460-519.9 Diseases of the Respiratory System | 15.5 | (13.6-17.4)(13.7-17.5) | 13.7 | (13.2-14.1) | 1.2 | (1.00.99-1.3) | ‡1.3 | (1.1-1.5) |
| 464-466.19, 480-488.9, 507-507.8, 510-510.9, 513-513.1 Pneumonia, Aspiration Pneumonitis and Other Infections |
9.3 | (7.9-10.68.0-10.7) | 6.2 | (5.9-6.65) | ‡1.5 | (1.3-1.8) | ‡1.6 | (1.3-1.9) |
| 490-493.92 Asthma, COPD and Chronic Bronchitis | 2.5 | (1.89-3.43) | 4.0 | (3.8-4.2) | ‡0.6 | (0.5-0.8) | ‡0.7 | (0.5-0.9) |
| 518.5, 518.81-518.85, 799.0-799.1 Asphyxia and Respiratory Failure |
2.9 | (2.2-4.02.0-3.9) | 0.40.38 | (0.32-0.44) | ‡8.0 | (5.6-11.5) | ‡2.6 | (1.8-3.7) |
| 520-579.9 Diseases of the Digestive System | 8.4 | (7.1-9.87) | 8.4 | (8.1-8.6) | 1.0 | (0.8-1.2) | 0.9 | (0.8-1.1) |
|
580-629.9 Diseases of the Genitourinary
System |
14.9 | (13.21-16.87) | 7.1 | (6.9-7.4) | ‡2.3 | (2.0-2.6) | ‡1.8 | (1.5-2.1) |
| 584-586 - Acute and Chronic Renal Failure | 33.0 | (2.2-3.8) | 0.5 | (0.4-0.6) | ‡6.4 | (4.8-8.6) | ‡2.3 | (1.6-3.2) |
| 590-590.9, 599.0 Pyelonephritis, kidney and urinary tract infections |
10.0 | (8.3-11.65-11.8) | 3.0 | (2.9-3.1) | ‡3.6 | (3.0-4.3) | ‡2.2 | (1.8-2.7) |
|
630-679.9 Complications of Pregnancy,
Childbirth, and the Puerperium |
**99.80.2 | (99.5-100.1)(0.05-0.85) | 98.41.6 | (98.3-98.5)(1.5-1.7) | **0.1N/A | (0.0-0.5) | **1.1N/A | (0.3-4.6) |
|
680-709.9 Diseases of the Skin and
Subcutaneous Tissue |
3.4 | (2.5-4.2)(2.6-4.3) | 4.9 | (4.7-5.1) | ‡0.7 | (0.5-0.9) | 1.0 | (0.8-1.4) |
| 681-686.9 Cellulitis and skin infections | 2.1 | (1.4-2.8)(1.5-2.9) | 3.1 | (3.0-3.3) | ‡0.7 | (0.5-0.9) | 0.9 | (0.6-1.3) |
|
710-739.9 Diseases of the Musculoskeletal
System and Connective Tissue |
4.5 | (3.3-5.6)(3.4-5.8) | 7.7 | (7.4-8.0) | ‡0.6 | (0.4-0.7) | ‡0.5 | (0.4-0.7) |
| 740-759.9 Congenital Anomalies | **0.0 | (0.0-0.0) | 0.10.15 | (0.12-0.192) | **N/A | **N/A | ||
|
760-779.9 Certain Conditions Originating in
the Perinatal Period |
**0.0 | (0.0-0.0) | 0.10.07 | (0.1-0.1)(0.05-0.09) | **N/A | **N/A | ||
|
780-799.9 Symptoms, Signs, and Ill-Defined
Conditions |
31.0 | (28.54-33.65) | 25.5 | (24.6-26.3) | ‡1.3 | (1.2-1.5) | ‡0.8 | (0.7-1.00.97) |
| 780.0-780.2, 780.97 Syncope, Coma and Altered Mental Status |
5.3 | (4.21-6.54) | 1.5 | (1.4-1.6) | ‡3.7 | (3.0-4.6) | ‡1.3 | (1.05-1.7) |
| 276.5-276.52, 458-458.9, 785.5-785.51, 785.59, 958.4, 995.0, 999.4 Shock, Hypovolemia, Dehydration, Hypotension and Anaphylaxis |
8.1 | (6.8-9.49-9.5) | 1.6 | (1.5-1.7) | ‡5.4 | (4.5-6.5) | ‡2.6 | (2.0-3.2) |
| 800-950.9 Injury | 18.0 | (16.4-19.7) | 23.8 | (23.3-24.3) | ‡180.7 | (16.4-19.7)(0.6-0.8) | 23.80.9 | (23.3-24.3)(0.8-1.01) |
| 800-804.9, 850.-854.9, 959.0-959.09 Head and brain injuries |
2.1 | (1.3-2.8)(1.4-3.0) | 1.9 | (1.8-2.0) | 1.1 | (0.7-1.6) | 1.1 | (0.7-1.7) |
| 805-806.9, 952.-952.9 Spinal cord injuries | **0.4 | (0.12-0.97) | 0.20.15 | (0.1-0.2)(0.12-0.18) | **2.8N/A | (1.3-6.2) | **1.2N/A | (0.5-2.7) |
| 860.-869.9 Chest, abdomen and pelvis injuries | **0.01 | (0.0-0.100) | 0.10.11 | (0.1-0.1)(0.09-0.14) | **0.1N/A | (0.0-1.0) | **0.2N/A | (0.0-1.2) |
| 807-839.9, 885-887.7, 895-897.7, 900-904.9, 925-929 Extremity fractures and injuries | 5.4 | (4.2-6.5)(4.3-6.6) | 3.8 | (3.6-3.9) | ‡1.4 | (1.1-1.8) | 1.1 | (0.9-1.5) |
| 940-949.9 Burns | **0.14 | (-0.00.07-0.45)-0.3) | 0.43 | (0.4-0.5)(0.39-0.48) | **0.3N/A | (0.1-1.1) | **0.7N/A | (0.2-2.1) |
| 960-989.9 Poisonings and Toxic Effects | **0.3 | (0.1-0.6) | 0.90.94 | (0.9-1.0)(0.86-1.02) | **0.3N/A | (0.1-0.6) | **N/A0.9 | (0.9-1.0) |
| 996-999.9 Complications of Medical Care | 1.1 | (0.6-1.6) | 0.50.51 | (0.5-0.6)(0.46-0.57) | ‡2.2 | (1.4-3.5) | 1.3 | (0.8-2.1) |
|
Infection (including lung, kidney, skin infections and sepsis - see Appendix 2 for ICD-9 code ranges) |
23.7 | (21.3-26.21) | 16.5 | (16.1-16.9) | ‡1.6 | (1.4-1.8) | ‡1.6 | (1.4-1.8) |
| 003.1, 022.3, 031.2, 038-038.9, 040.82, 422.92, 449, 659.3, 670.20-670.24, 673.3, 771.81, 771.83, 785.52, 790.7, 995.90-995.94 Sepsis, Septicemia, Bacteremia and Septic Shock |
3.8 | (2.8-4.9) | 0.20.23 | (0.2-0.3)(0.19-0.26) | ‡17.6 | (13.1-23.6) | ‡6.2 | (4.1-9.5) |
Ref = referent category. ED = Emergency Department. MSA = metropolitan statistical area. OR = Odds Ratio. CI = Confidence Interval.
‡
Significant at p<0.05.
**
Based upon fewer than 30 raw observations - estimate considered unreliable; ORs not calculated for these variables.28