Milford Regional's Chief Medical Officer Authors Article on Factors Associated with Older Patients' Admissions

Milford Regional Medical Center’s Chief Medical Officer Peter Smulowitz, MD, MPH was the lead author of an article published in the Journal of the American Medical Association (JAMA) Internal Medicine. The article, Association of Functional Status, Cognition, Social Support, and Geriatric Syndrome With Admission From the Emergency Department, examines the results of a study that evaluated key factors associated with admitting older patients to the hospital following their visit to the Emergency Department.

“We know that Emergency Department clinicians factor in the medical condition and how “sick” a patient is when determining whether a patient needs to be admitted or not,” said Smulowitz. “However, there are a number of other often overlooked factors that play into this decision, among which are some common challenges associated with an aging population.”

In the cohort study of 42,392 Emergency Department visits by 11,783 unique patients, the key finding indicates that functional status, cognitive status and social supports were associated with an increase in the likelihood of admission from the Emergency Department.

The study’s data makes evident the connection between certain patient-level factors and whether there is a perceived need to admit. “This study demonstrates that specifically physicians seem to recognize these factors and take them into consideration when deciding whether to admit older patients or not,” Smulowitz said.

According to Smulowitz, understanding these factors should encourage health systems and insurers to invest more resources to support older adults who do not require hospitalizations, from a medical standpoint.

“This could mean an investment in case management, home health, support for personal care attendants, staffing for units for patients with cognitive decline, and other mechanisms to help keep our older adults safely out of the hospital,” said Smulowitz. “It also points out the important role that families can play in supporting their older relatives. With an aging population, there is going to be a greater need for families to play an active role in the care of their loved ones, especially in order to prevent them from a trip to the hospital.”

JAMA Internal Medicine is a monthly, peer-reviewed medical journal published by the American Medical Association.

Co-Authors of the published piece include: Gabe Weinreb, BA; J. Michael McWilliams, MD, PhD; A. James O’Malley, MS, PhD; and Bruce E. Landon, MD, MBA, MSc.

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Milford Regional Medical Center is a full-service, community and regional teaching hospital located in Milford, Mass. and serves patients from more than 20 towns in Central Massachusetts. The 148-bed medical center is a nonprofit, acute-care facility, where more than 300 primary care and specialty physicians are committed to providing exceptional healthcare services to our community with dignity, compassion and respect.