Aims: Those living in residential care facilities (RCFs) have frequent visits to Emergency Departments (EDs). The aim of this study was to determine the secular trend of ED use among older people in Western Australia (WA).
Methods: Study population consisted of individuals registered on the WA Electoral Roll aged >65 years, between 1 January 2002 and 31 December 2019. Linked data were available from Emergency Department, Inpatient Hospital system, Mortality Register, Cancer Registry, Mental Health Services and Aged Care Assessment Program. Differences in number of admissions from RCF versus non-RCF, were calculated by rate ratios (RRs), after standardization. Logistic regression was used to investigate association of living in RCF with being diagnosed with specific conditions, controlling for age and sex.
Results: 2,233,493 presentations and 397,619 individuals were included in this study. In the period 2002-2019, the adjusted RR for all ED presentations for RCF/Non-RCF residents decreased from 11.8 to 1.8. Similarly, the RR for injury, hip fracture, circulatory disorders, and neoplasm decreased to less than 2. In 2019 the RR for mental disorders were 4.8, urinary tract infection was 3.7, and lower respiratory tract infection was 3.1. In contrast, RCF residents were less likely to be diagnosed with circulatory disorders OR 0.86, (95% CI:0.84–0.88) and neoplasm, OR 0.38 (95% CI:0.35–0.42).
Conclusions: The overall relative use of ED by RCF residents decreased over time. RCF residents continued to have an increased risk of presenting with certain diagnoses such as mental disorders, urinary tract infections and lower respiratory tract infections.