Older People Who are Frequent Users of Acute Care: A Symptom of Fragmented Care? A Case Series Report on Patients’ Pathways of Care


Older frequent users of acute care can experience fragmented care. There is a need to understand the issues in a local context before attempting to address fragmented care. 0.5% (n=61) of the population in a defined local government area were identified as having ≥4 unplanned emergency department (ED) presentations/ admissions to an acute-care hospital over 13 months. A retrospective case-series study was conducted to examine detailed pathways of care for 17 patients within the identified population. The two dominant presentation reasons were clinical symptoms associated with a declining/significant loss of capacity in fundamental self-care activities and chronic cardiac/respiratory conditions. Of patients discharged home, 21% of discharge letters were delayed >7 days and only 19% received a written discharge plan. Half of community dwelling patients received home nursing and/or assistance. Frequent users of acute care can experience untimely hospital communication and may require more coordinated care provided in the community to assist self-care and manage chronic conditions.

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Correspondence to Joanne Dollard.

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Dollard, J., Harvey, G., Dent, E. et al. Older People Who are Frequent Users of Acute Care: A Symptom of Fragmented Care? A Case Series Report on Patients’ Pathways of Care. J Frailty Aging 7, 193–195 (2018). https://doi.org/10.14283/jfa.2018.12

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Key words

  • Frail elderly
  • aged
  • ambulatory care
  • disease management
  • hospital/*utilization
  • delivery of health care
  • integrated