Abstract
ObjectivesThis study aimed to characterize ambulatory care patterns among older adults discharged from the emergency department (ED).MethodsThis retrospective cohort study of 55,391 ED visits from the 2015-2021 Medicare Current Beneficiary Survey examined ambulatory follow-up within 7 and 30 days. Care fragmentation was assessed by identifying visits where patients saw 2+ different providers. Zero-inflated negative binomial models analyzed associations between patient characteristics (e.g., dementia, multiple chronic conditions) and follow-up.ResultsFollow-up occurred in 22.9% and 44.2% of cases within 7 and 30 days, respectively. Care fragmentation occurred in 4.6% and 25.3% of cases. Dementia reduced follow-up odds (OR 0.74; 95% CI 0.66-0.84; p < 0.001), while multiple chronic conditions increased them (OR 1.27; 95% CI 1.19-1.36; p < 0.001).DiscussionMost older adults lack timely ED follow-up, and care can be fragmented. These patterns highlight the need for interventions to balance access and fragmentation while improving outcomes.