California’s over-65 population is entering a period of rapid growth as more people are living longer and healthier lives. According to the Public Policy Institute of California, by 2030, as the Baby Boom generation reaches retirement age, the senior population will grow by four million people. Innovations in healthcare have helped make that increased longevity possible, but now a new wave of innovations in healthcare delivery and community-based services must emerge to reflect our state’s changing demographic.
One of these innovations is already occurring within emergency departments (EDs), which are increasingly becoming our nation’s “front porch” of healthcare for older adults. In 2013, one out of every two older adults made an ED visit, a large proportion of which resulted in hospital admission.1;2 Additionally, a significant percent of seniors discharged from the ED are readmitted to the ED within days. For example, in 2011, California’s seniors accounted for approximately 1.3 million visits to the ED and nearly 16 percent of the seniors who were discharged revisited within 30 days.3
The ED serves as a critical entry point to the healthcare system where people are either admitted or discharged, setting the stage for the future of care.4;5 Early data from existing models of geriatric emergency care—models that promote best clinical practices for seniors and create a more positive and sensitive physical environment, for example, show they have the potential to improve health outcomes, coordinate care more effectively and reduce costs.4;6;7;8
Policy makers have an increased interest in advancing innovative, person-centered, scalable and sustainable models of geriatric-focused acute care. New policies, coupled with increased use of technology to provide care, serve to advance large-scale changes in clinical care and ED policies in hospitals across the country to improve the health, safety and independence of seniors requiring acute care.
Through a combination of applied medical research, policy and advocacy, and outcomes-based philanthropy, West Health is working to create and foster new integrated care models that improve health outcomes and better address both the medical and non-medical needs of seniors and their families. Our Gary and Mary West Health Institute, Gary and Mary West Health Policy Center and Gary and Mary West Foundation all work together under the umbrella of West Health, with a shared mission to enable successful aging for our nation’s seniors.
Below are two examples of our research efforts in California:
1. A Profile of Older Americans: 2014. Administration on Aging. Administration for Community Living. U.S. Department of Health andHuman Services. (2014).
2. Healthcare Cost and Utilization Project: Nationwide Emergency Department Sample. Analyzed by West Health Institute.
3. Healthcare Cost and Utilization Project: The State Emergency Department Databases – California. (2011) Analyzed by West Health Institute.
4. Burke, et al., (2015). Identifying Potentially Preventable Emergency Department Visits by Nursing Home Residents in the United States. Journal of the American Medical Directors Association. Volume 16, Issue 5. 1 May 2015. Pages 395-399.
5. Hwang, U., Shah, M.N., Han, J.H., Carpenter, C.R., Siu, A.L., & Adams, J.G. (2013). Transforming emergency care for older adults. Health Affairs (Millwood), 32(12), 2116-2121. doi: 10.1377/hlthaff.2013.0670
6. Carpenter, C.R., & Platts-Mills, T.F. (2013). Evolving prehospital, emergency department, and “inpatient” management models for geriatric emergencies. Clinical Geriatric Medicine, 29(1), 31-37. doi: 10.1016/j.cger.2012.09.003
7. Aldeen, A.Z., Courtney, D.M., Lindquist, L.A., Dresden, S.M., & Gravenor, S.J. (2014). Geriatric emergency department innovations: Preliminary data for the geriatric nurse liaison model. Journal of the American Geriatrics Society, 62(9), 1781-1785. doi:10.1111/jgs.12979
8. Rudzen, C., Richardson, L.D., Baumlin, K.M., Winkel, G., Davila, C., Ng, K., Hwang, U., & GEDI WISE Investigators. (2015). Redesigned geriatric emergency care may have helped reduce admissions of older adults to intensive care units. Health Affairs, 34(5), 788-795. doi:10.1377/hlthaff.2014.0790
9. California Emergency Department Visit Rates For Medical Conditions Increased While Visit Rates For Injuries Fell, 2005–11. Renee Y. Hsia, Julia B. Nath, and Laurence C. Baker. Health Affairs 2015 34:4, 621-626