Emergency department presentations of older patients in Germany: high rates of ambulatory care–sensitive conditions and increased odds of inpatient mortality in patients living with dementia
Dublin Core
Title
Emergency department presentations of older patients in Germany: high rates of ambulatory care–sensitive conditions and increased odds of inpatient mortality in patients living with dementia
Subject
Emergency department, Geriatric emergency care, Dementia, Cross-sectoral healthcare
Description
Background The crowding of emergency departments (ED) in Germany and many other countries has been a well-
known problem and the ageing population is posing additional and very specific challenges to EDs as older patients
may present with multimorbidity, polypharmacy, frailty, dementia and non-specific complaints. The primary aim of
this study was to characterize clinical and demographic features of emergency department (ED) patients aged ≥70
years in Germany, and to analyse their outpatient care utilization before the ED visit. The secondary aim was to explore
the relationship between dementia and inpatient mortality.
Methods Routine hospital data from 16 German EDs from 2016 were linked to outpatient care data from 2014
to 2017. The demographic and clinical characteristics of ED patients ≥70 years were evaluated for the four billing
quarters preceding the first ED visit in 2016. The relationship between dementia and inpatient mortality was assessed
using a directed acyclic graph and a generalized linear mixed model adjusted for confounders (e.g., age, sex,
comorbidities) and ED centre.
Results In 2016, 99,858 patients aged≥70 years presented to one of the 16 EDs. Most arrived via medical
transportation (60.5%). Whilst 31.2% were triaged as less urgent, 64.2% were admitted as an inpatient. Among
the most common ED diagnoses were several ambulatory care–sensitive conditions (ACSC). Although 84.1% of
patients having had regular contact (i.e., in ≥3 billing quarters) with a general practitioner, geriatric assessment was
only conducted in 45.7% of patients; 60.2% of ED patients were taking five or more medications (polypharmacy).
ED patients with dementia (n=14,511) had increased odds of inpatient mortality (adjusted odds ratio 1.18;
95%-confidence interval 1.08–1.28).
known problem and the ageing population is posing additional and very specific challenges to EDs as older patients
may present with multimorbidity, polypharmacy, frailty, dementia and non-specific complaints. The primary aim of
this study was to characterize clinical and demographic features of emergency department (ED) patients aged ≥70
years in Germany, and to analyse their outpatient care utilization before the ED visit. The secondary aim was to explore
the relationship between dementia and inpatient mortality.
Methods Routine hospital data from 16 German EDs from 2016 were linked to outpatient care data from 2014
to 2017. The demographic and clinical characteristics of ED patients ≥70 years were evaluated for the four billing
quarters preceding the first ED visit in 2016. The relationship between dementia and inpatient mortality was assessed
using a directed acyclic graph and a generalized linear mixed model adjusted for confounders (e.g., age, sex,
comorbidities) and ED centre.
Results In 2016, 99,858 patients aged≥70 years presented to one of the 16 EDs. Most arrived via medical
transportation (60.5%). Whilst 31.2% were triaged as less urgent, 64.2% were admitted as an inpatient. Among
the most common ED diagnoses were several ambulatory care–sensitive conditions (ACSC). Although 84.1% of
patients having had regular contact (i.e., in ≥3 billing quarters) with a general practitioner, geriatric assessment was
only conducted in 45.7% of patients; 60.2% of ED patients were taking five or more medications (polypharmacy).
ED patients with dementia (n=14,511) had increased odds of inpatient mortality (adjusted odds ratio 1.18;
95%-confidence interval 1.08–1.28).
Creator
Kristina Hartl1,2, Anna Slagman1
, Martin Möckel1
, Hanna Winkler3
, Liane Schenk4
, Thomas Keil3,5,6 and
Dorothee Riedlinger1*
, Martin Möckel1
, Hanna Winkler3
, Liane Schenk4
, Thomas Keil3,5,6 and
Dorothee Riedlinger1*
Source
https://doi.org/10.1186/s12873-025-01458-8
Date
2026
Contributor
PERI IRAWAN
Format
PDF
Language
ENGLISH
Type
TEXT
Files
Collection
Citation
Kristina Hartl1,2, Anna Slagman1
, Martin Möckel1
, Hanna Winkler3
, Liane Schenk4
, Thomas Keil3,5,6 and
Dorothee Riedlinger1*, “Emergency department presentations of older patients in Germany: high rates of ambulatory care–sensitive conditions and increased odds of inpatient mortality in patients living with dementia,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12058.