Background: This study aimed to determine to what extent an aging population and shift to chronic illness has contributed to emergency admissions at a tertiary care hospital over ten years.
Methods: This was a retrospective observational study performed using a database of all emergency admissions from the Emergency Department (ED) at a single tertiary hospital in Singapore during a ten-year period (January 1st, 2008 to December 31st, 2017). Emergency admissions were defined as ED visits with inpatient admission as the disposition. This study analyzed the trends of demographics, pre-existing comorbidities, chronic conditions or ambulatory care sensitive conditions (ACSC) of all patients who underwent emergency admissions in SGH.
Results: A total of 446,484 emergency records were included. While the annual number of emergency admissions increased by 22% from 2008 to 2017, the rate of emergency admissions for the Singapore elderly population (aged >65 years) had a relative decrease of 15% during the same period. For elderly patients, lower proportions of them had pre-existing multimorbidity at the time of undergoing emergency admissions. The proportions of emergency admissions whose ED primary diagnoses were categorized as chronic conditions and certain chronic ACSC including chronic obstructive pulmonary disease, congestive heart failure, diabetes complications, and epilepsy also decreased for elderly patients.
Conclusions: In Singapore, despite a rapidly ageing population, there have been surprisingly fewer chronic conditions, pre-existing comorbidities, and chronic ACSC among the elderly emergency admissions. This is possibly consistent with an overall improved management of the chronic conditions among the elderly population and will be interesting to compare with other healthcare settings in different countries in future studies.