Risk factors for frequent emergency department visits of veterans home residents in Northern Taiwan

PurposeThe purpose of this study was to evaluate risk factors for frequent emergency department (ED) visits among older Chinese men living in a veterans home in northern TaiwanMethodsIn 2006, all residents of Banciao Veterans Home were invited for study. Minimum Data Set Nursing Home 2.1 Chinese version, Chinese version of Geriatric Depression Scale (GDS) short form, mini-mental status examinations (MMSE), and Charlson Comorbidity Index (CCI) were used for study. ED records of all study participants were obtained from Taipei Veterans General Hospital, and frequent ED visitors were defined as who visited ED for three times or more in 1 year.ResultsOverall, 609 residents (mean age = 80.9 ± 5.3 years, all men) were enrolled, and 169 (27.8%) of them visited the ED for at least once. Among all participants, 30 (4.9%) were frequent ED visitors. Frequent ED visitors were significantly older, disabled, cognitively impaired, depressed, urinary incontinent, having poorer social engagement score, and higher Charlson’s comorbidity index (CCI). Adjustments for age, activities of daily living, depression, cognitive impairment (adjusted odds ratio: 3.19; 95% confidence interval: 1.37–7.46, p = 0.004) and higher CCI (adjusted odds ratio: 1.69; 95% confidence interval: 1.20–2.39, p = 0.003) were independent risk factors for frequent ED visits.ConclusionThe cumulative incidence of ED visit was 51 visits per 100 person-years, and the prevalence of frequent ED visitors was 4.9% among older veterans living in a Veterans Home. Cognitive impairment and higher Charlson’s comorbidity index were independent risk factors for frequent ED visitors. Further study is needed to explore the unmet health-care needs for frequent ED visitors in the veterans home.