ArticleJournal of the American Geriatrics Society2025
Drivers of Frequent Emergency Department Use in Socioeconomically Disadvantaged Older Adults: A Qualitative Study.
Article in Journal of the American Geriatrics Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- How do existing HRSN assessment tools assess social needs for older adults? A systematic review.Frontiers in health services · 2026Pooled it
- Emergency Department Encounters Preceding Hip Fracture in Older Adults: A Window for Future Risk Identification.Journal of the American College of Emergency Physicians open · 2026Article
- Treatment Adherence and Health Care Utilization After a First Episode of Psychosis.JAMA network open · 2026Article
- Dementia Screening in the Emergency Department: A Communication-Centered Process.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Article
- Review
- A Qualitative Study of Health Priorities of People With Dementia and Care Partners in Emergency Department and Hospital Care in a Public Safety-Net Setting.Journal of the American Geriatrics Society · 2025Article
- Drivers of Frequent Emergency Department Use in Socioeconomically Disadvantaged Older Adults: A Qualitative Study.Journal of the American Geriatrics Society · 2025Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundThe emergency department (ED) is the safety net for and a common point of healthcare access for socioeconomically disadvantaged older adults. Little is known about socioeconomically disadvantaged older ED patients' perspectives on their health, healthcare access, and ED use. Such insights could guide tailored interventions to address unmet clinical and health-related social needs (HRSN).
methodsWe performed a qualitative study with older adults in a single public safety net hospital ED. We interviewed patients age 60+ who had ≥ 4 ED 4 visits in the past year. Semi-structured interviews explored perceived health needs and motivations underlying ED visits. We screened for HRSN using validated measures. We performed content analysis to evaluate key drivers of ED use based on Andersen's Behavioral Model of Health Services Use and used principles of narrative analysis to identify distinct profiles of older patients with frequent ED use.
resultsAmong 68 interview participants, 40% identified as Black and 43% as Hispanic. Sixty percent had health insurance. Most participants (63%) reported HRSN, but rarely described these as primary drivers of ED use. Instead, poor access to outpatient care and medical complexity related to condition-specific needs were the most salient factors. Six distinct profiles emerged of patients who: (1) lacked insurance and primary care; (2) faced an acute condition; (3) held acute concerns related to serious underlying diseases; (4) had chronic disease whose management bordered between outpatient and inpatient settings; (5) had a sentinel event (e.g., fall, surgery) with cascading sequelae; (6) faced recurrent challenges managing indwelling catheters, tubes, and long-term vascular access.
conclusionsAmong socioeconomically disadvantaged older adults in our sample, medical complexity was a more salient driver of frequent ED use than unmet social needs. Innovations to strengthen outpatient care and offer alternatives to ED and hospital admission are needed for this population.
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