Acute medical care resource utilization of frail older patients presenting at the emergency department

Abstract Purpose The emergency department (ED) has changed significantly due to technical innovations, centralization of care and further medical specialization. It is critical to assess whether the ED remains the most appropriate setting for older (frail) patients, given their multimorbidity, differing life goals, and the need to maintain acute care accessible. Methods This study assesses ED visits, focusing on differences in acute medical care resource utilization between younger and older patients, including the impact of age and frailty. A retrospective case series was performed over nearly six years, using descriptive trend analysis and multivariable regression. Results This study included 163,140 patients, accounting for 274,462 ED visits. Median age was 46 years (IQR 25–66), and 48.5% were female. Patients aged ≥ 70 years (21.5% of visits) demonstrated higher use of acute care resources, including laboratory tests (OR 1.49), X-rays (OR 1.97), CT scans (OR 1.78), ambulance transport (OR 2.98), specialist consultations (OR 1.80), and hospital admissions (OR 2.83) compared to younger patients. Frail older patients had even greater utilization, independent of age, with adjusted ORs of 2.54 for ambulance transport and 4.45 for consultations. Conclusion Older, especially frail, patients utilize more acute medical care resources and are more frequently hospitalized than younger individuals. These findings support the need for holistic, transmural care models that better align with patients’ needs and reduce potentially non-beneficial interventions. The current ED setting may not be optimal for delivering such care. Tailored care pathways and alternatives to conventional hospitalization may improve patient outcomes and healthcare sustainability.