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Research Letter |

Trends in Emergency Department Visits for Ambulatory Care Sensitive Conditions by Elderly Nursing Home Residents, 2001 to 2010

Julia Brownell, BA1; Joseph Wang, BS2; Alexander Smith, MD, MS, MPH3,4; Caroline Stephens, PhD, MSN, APRN, BC4,5; Renee Y. Hsia, MD, MSc1
[+] Author Affiliations
1Department of Emergency Medicine, University of California, San Francisco
2medical student, School of Medicine, University of California, San Francisco
3Division of Geriatrics, Department of Medicine, University of California, San Francisco
4Geriatrics, Palliative and Extended Care, San Francisco Veterans Affairs Medical Center
5Department of Community Health Systems, University of California, San Francisco
JAMA Intern Med. 2014;174(1):156-158. doi:10.1001/jamainternmed.2013.11821.
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Despite having 24-hour access to health care professionals, nursing home residents have disproportionately high rates of emergency department (ED) visits, a large portion of which are potentially preventable.1,2 These acute care visits, often classified as potentially preventable using ambulatory care sensitive conditions (ACSCs), can be harmful to residents’ functional outcomes relative to treatment in their familiar setting.3 Given the increase in reporting and enforcement of the Centers for Medicare & Medicaid Services’ regulations about nursing home quality, we hypothesized that the rate of ED visits for ACSCs by elderly nursing home patients had declined during the last decade.

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Figure.
Rates of Emergency Department (ED) Visits per 1000 US Nursing Home Residents for Ambulatory Care Sensitive Conditions (ACSCs), Non-ACSCs, and Overall, 2001 to 2010

Visit numbers and corresponding visit rates from 2001 to 2004 were adjusted by 0.92 to account for non–nursing home, institutionalized patients (see the eMethods in the Supplement).

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