ArticleBMC health services research2020
Emergency department and inpatient utilization among U.S. older adults with multiple chronic conditions: a post-reform update.
Article in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Association between multimorbidity and hospitalization in older adults: systematic review and meta-analysis.Age and ageing · 2022Pooled it
- Factors Associated with Emergency Department Utilization among Older Black Adults with Chronic Illness in the United States.Journal of racial and ethnic health disparities · 2026Article
- Novel Electronic Health Record Strategies to Identify Frailty Among Hospitalized Older Adults with Multiple Chronic Conditions.Journal of general internal medicine · 2025Article
- Nurse Practitioner Care Environments and Provider Shortages Among Patients With Multiple Chronic Conditions.Research in nursing & health · 2025Article
- Article
- Emergency services utilization by patients with alcohol-associated hepatitis: An analysis of national trends.Alcohol, clinical & experimental research · 2024Article
- Factors Associated With Health Care Delays Among Adults Over 50 During the COVID-19 Pandemic.The journals of gerontology. Series A, Biological sciences and medical sciences · 2023Article
- Emergency Department Utilization, Hospital Admissions, and Office-Based Physician Visits Among Under-Resourced African American and Latino Older Adults.Journal of racial and ethnic health disparities · 2023Article
- Scalar Assessment of the Family Caregiver Activation in Transitions Tool: An Exploratory Factor Analysis.Journal of gerontological nursing · 2022Article
- Emergency physician perspectives on using telehealth with older adults during COVID-19: A qualitative study.Journal of the American College of Emergency Physicians open · 2021Article
- Health information technology to improve care for people with multiple chronic conditions.Health services research · 2021Review
- Disparities in insurance coverage among hospitalized adult congenital heart disease patients before and after the Affordable Care Act.Birth defects research · 2021Article
- Predictors of Retention for Community-Based Telehealth Programs: A Study of the Telehealth Intervention Program for Seniors (TIPS).AMIA ... Annual Symposium proceedings. AMIA Symposium · 2021Article
Corrections and comments
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Authors and funding
4 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundThe Affordable Care Act (ACA) was enacted to enhance access to care primarily among nonelderly and low-income populations; however, several provisions addressed key determinants of emergency department (ED) and inpatient visits among Medicare beneficiaries over age 65 years. We take stock of the overall changes in these visits among older Medicare beneficiaries, focusing on those with multiple chronic conditions (MCCs), and provide a nationally representative post-reform update.
methodsWe analyzed a sample of 32,919 older adults (65+) on Medicare from the 2006-2015 Medical Expenditure Panel Survey (MEPS). Using a survey-weighted two-part model, we examined changes in ED visits, inpatient visits, and length of stay (LOS) by MCC status, before (2006-2010), during (2011-2013), and after the ACA (2014-2015).
resultsPrior to the ACA, 18.1% of Medicare older adults had ≥1 ED visit, whereas 17.1% had ≥1 inpatient visits, with an average of 5.1 nights/visit. Following ACA reforms, among those with 2+ chronic conditions, the rate of ever having an ED visit increased by 4.3 percentage points [95% confidence intervals [CI]: 2.5, 6.1, p < 0.01], whereas the rate of inpatient visits decreased by 1.4 percentage points [95%CI: - 2.9, 0.2, p < 0.1], after multivariable adjustment.
conclusionsWe found sizable increases in ED visits and nontrivial decreases in inpatient visits among older Medicare beneficiaries with MCCs, underscoring the continuing need for improving access to and quality of care among older adults with MCCs to decrease reliance on the ED and reduce preventable hospitalizations.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.