Return visits to the emergency department and related hospital admissions by people aged 65 and over.

AIM: To describe the factors most commonly associated with re-presentation to the emergency department (ED) and related hospital admissions by those aged 65 years and over in one New Zealand district health board (DHB) region.
METHODS: Computerised and paper-based records of 59 patients were examined. The sample was selected using proportionate stratified random sampling to ensure equivalent proportions of patients re-presenting to the tertiary hospital's ED and the secondary hospital's accident and medical department.
RESULTS: Those who re-presented to the ED within 3 months had an average of 3.4 comorbidities. Hypertension and ischaemic heart disease were the most common comorbidities. Abdominal pain, chest pain and shortness of breath were the most frequently presenting complaints. Patients were less likely (p=0.05) to re-present within 7 days if their capacity to mobilise prior to presentation, and on discharge, was documented. Few patients were instructed to see their primary care provider within any given timeframe.
CONCLUSION: Better documentation about changes in levels of function, both prior to presentation and on discharge, is needed to ensure that patients are physically able to manage at home. Specific interventions could be targeted to improve function if needs have been identified. The frequency of cardiovascular comorbidities and cardiac discharge diagnoses suggest that those aged 65 years and over re-present with an acute illness and not because of failure to cope at home. Findings support early primary healthcare follow-up since the majority of re-presentations occur within 2 weeks.