How Frequently do Older People in Ireland attend the Emergency Department and what Factors influence ED Attendance? A Population-Based Analysis

Abstract Background Older people in Ireland are increasingly presenting to Emergency Departments (ED) for unscheduled care. The aim of this study was to examine the frequency of ED presentation over 12 months in a large sample of older people from a large longitudinal study. Methods A population-representative sample of over 2,300 people aged ≥70 years (mean age 77 years, 55% female) were asked to report the number of ED attendances over the last 12 months. Data was extrapolated to 2022 census figures by the Central Statistics Office to estimate population-based figures. Additional data was collected including health behaviours, chronic disease burden and socioeconomic factors, with logistic regression models assessing the association of these variables with ED attendance. Results Almost one fifth (19% (95% CI 17–21) of older people in Ireland attended the Emergency Department in the last 12 months. This includes 14% (95% CI 12–15) aged 70-74 years; 19% (95% CI 16–23) aged 75-79 years; 20% (95% CI 15–24) aged 80-84 years and 27% (95% CI 22–33) aged ≥85 years. When extrapolated to census data, 99,828 older people reported an ED attendance in the last 12 months, including 22,799 people aged ≥85 years. Factors associated with ED attendance were Age 85+ (Odds Ratio 1.77 (95% CI 1.29 – 2.44); ≥2 Chronic Diseases (Odds Ratio 1.66 (95% CI 1.23 – 2.25) and Heart Disease (Odds Ratio 2.63 (95% CI 1.86 – 3.72), while tertiary education was associated with lower likelihood Ed attendance (Odds Ratio 0.65 (95% CI 0.48 – 0.87)). Conclusion A significant proportion of older people in Ireland attend the ED for unscheduled care, and the number of attendances will likely increase significantly in coming years. Addressing the needs of older people in the ED requires an age-attuned approach, implementing comprehensive geriatric assessment at the hospital front door.