Systematic Review: Factors associated with increased Emergency Department transfer in older long-term care residents

The proportion of adults older than 65 years is rapidly increasing. Care home residents in this age group have disproportionate rates of transfer to the Emergency Department (ED) and around 40% of attendances might be avoidable.Observational studies that provided estimates of association between ED attendance and variables at a resident or care home level were included. Seven common domains of factors assessed for association with ED transfer were identified and within these domains, male sex, age, presence of specific comorbidities, polypharmacy, rural location, and care home quality rating were associated with likelihood of ED transfer. Our product, Dr. Triage, combats the majority of the commonly identified risk factors while improving efficiency and the cost burden for skilled nursing home facilities.