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Risk of emergency department use among community-dwelling older adults: a review of risk factors and screening methods

Andrew P Costa, Karen Harkness, Dilys Haughton, George A Heckman and Robert S McKelvie

Growing use of emergency departments (EDs) among community-dwelling older adults represents a challenge for the entire health system and a potential opportunity for improved identification and management among community healthcare providers. Studies have examined risk factors for ED visits among samples of noninstitutionalized older adults. They suggest that need for care characteristics are robust risk factors for ED use. Six screening tools have been developed or validated to predict ED utilization among community-dwelling older adults. Some evidence suggests that risk screening tools are useful to stratify patients into meaningful risk gradients. Future empirical studies should employ a comprehensive set of potential risk factors and utilize contemporary risk modeling methods to improve existing knowledge and risk screeners.