30‐Day Emergency Department Revisit Rates among Older Adults with Documented Dementia

Older adults with dementia are significantly more likely to revisit the emergency department (ED) within 30 days compared to those without dementia, with revisit rates of 22% versus 13.9%. This difference remains even after adjusting for factors such as age, sex, comorbidities, Medicaid status, and prior healthcare utilization, with dementia increasing the odds of a revisit by 27% (odds ratio of 1.27). The study utilized national Medicare claims data from 2015–2016, comparing 54,622 patients with documented dementia to 240,249 without, focusing on the first outpatient ED visits in 2016.

The higher ED revisit rate among dementia patients highlights challenges in managing comorbidities and transitions of care. Patients with dementia often experience worse outcomes, such as increased hospitalizations and complications, which contribute to higher healthcare costs. Effective care coordination, involving primary care providers, emergency clinicians, and community-based services, is critical to addressing these gaps. Programs like the National Plan to Address Alzheimer’s Disease emphasize improving care transitions and leveraging ED visits to connect patients and caregivers to necessary resources.

Despite its insights, the study is limited by underdiagnosis and undercoding of dementia in claims data, as well as an inability to measure dementia severity or causality behind revisits. Nevertheless, it underscores the importance of proactive management, caregiver education, and integrated care to reduce ED utilization and improve outcomes for older adults with dementia. The findings point to the need for systemic changes to better support this vulnerable population and their caregivers.

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