Older Emergency Department Patients: Does Baseline Care Status Matter?

  • Fabrice Immanuel Mowbray Department of Health Research Methods, Evidence, and Impact. McMaster University
  • Komal Aryal McMaster University
  • Eric Mercier Université Laval
  • George Heckman University of Waterloo
  • Andrew P. Costa McMaster University
Keywords: older adults, emergency department, formal support services, home care, nursing care



Little is known about the prognostic differences between older emergency department (ED) patients who present with different formal support requirements in the community. We set out to describe and compare the patient profiles and patterns of health service use among three older ED cohorts: home care clients, nursing home residents and those receiving no formal support.


We conducted a secondary analysis of the Canadian cohort from the interRAI multinational ED study. Data were collected using interRAI ED contact assessment on patients 75 years of age and older (n = 2,274), in eight ED sites across Canada. A series of descriptive statistics were reported. Adjusted as­sociations were determined using logistic regression.


Older adults receiving no formal support services were most stable. However, they were most likely to be hospitalized. Older home care clients were most likely to report depressive symptoms and distressed caregivers. They also had the great­est odds of frequent ED visitation post-discharge (OR=1.9; 95% CI=1.39–2.59). Older adults transferred from a nursing home were the frailest but had the lowest odds of hospital admission (OR=0.14; 95% CI=0.09–0.23).


We demonstrated the importance of inquiring about commu­nity-based formal support services and provide data to support decision-making in the ED.


Author Biographies

Komal Aryal, McMaster University

1Department of Health Research Methods, Evidence and Impact

Eric Mercier, Université Laval

Département de Médecine Familiale et Médecine d’Urgence, Faculté de Médecine, Centre d’excellence sur le vieillissement, Centre de recherche sur les soins de première ligne de l’Université Laval

George Heckman, University of Waterloo

School of Public Health and Health Systems, Michael G. DeGroote School of Medicine, Waterloo Regional Campus

Andrew P. Costa, McMaster University

Department of Health Research Methods, Evidence and Impact, Michael G. DeGroote School of Medicine, Waterloo Regional Campus

How to Cite
Mowbray, F. I., Aryal, K., Mercier, E., Heckman, G., & Costa, A. P. (2020). Older Emergency Department Patients: Does Baseline Care Status Matter?. Canadian Geriatrics Journal, 23(4), 289-296. https://doi.org/10.5770/cgj.23.421
Original Research