ED Utilization and Self-Reported Symptoms in Community-Dwelling Older Adults.

This was an observational analysis of an existing cohort, so it can show associations but cannot show that symptoms, medications, daily-activity difficulty or balance caused emergency department use. The symptom measures recorded only presence or absence, not severity, and the authors say the scales may not be useful for practice. Monthly calls could be up to a month or more before an emergency visit, and the study did not measure acute symptoms or the time from symptom onset to the decision to seek emergency care. It did not measure access to primary care, social isolation, or why people with similar symptoms chose different care paths. Participants were all 75 years and older, had lower income than the general Alabama population, and Hispanic ethnicity was not captured, so results may not apply to younger or Hispanic older adults. No nurse-led transitional care program or therapy intervention was tested.

Do not conclude that treating pain, tiredness or breathlessness will prevent emergency visits. People who used the emergency department and those who did not reported similar symptoms, and the study did not test any intervention.