Health Safety: Causes of Adverse Health Events Among Community-Dwelling Elders

Ensuring safety in the home and community for elders is an important public health concern especially for elders as they age. A small-scale pilot study was conducted to retrospectively investigate the potential causes of adverse events that resulted in an emergency department visit at an academic hospital in Chicago among individuals aged 65 and older living in the community. Medical illness could comprise some, but not all of the factors involved in emergency visits, and that a root-cause approach would reveal additional factors amenable to preventive interventions in the community setting. The adverse health events that resulted in hospital admissions included falls, stomach pain, constipation, edema, chest pain, medication problems, visual changes, and weakness. Preventable contributing factors to these events fell into four general categories: (1) lack of care coordination and follow-up between healthcare providers and patient/informal caregivers; (2) financial barriers to medication or healthcare services; (3) lack of knowledge regarding emergency services; and (4) unsafe home environment. Future large-scale studies are needed to identify the root-causes of the events and analyze the relationship between causal factors and patient/caregiver characteristics. Once these are understood, interventions may be designed to improve the health and independence of this population.