An older adult patient who waits more than 6 hours in an emergency department (ED) before inpatient admission may lose her ability to live unassisted after discharge. Researchers evaluated discharge patterns of 277 patients who visited an ED in Rochester, N.Y., during August 2007. Of those given an inpatient bed within 6 hours, only about 4% were later discharged to a nursing home. Of those who stayed in the ED more than 6 hours, however, 18% were discharged to a nursing home. Ten percent of the patients stayed in the ED longer than 48 hours.

Researchers say that it's not good to keep anyone in the ED for a long time, but that older adults probably fare worse than younger patients. Other research has suggested that boarding patients in the ED is associated with increased mortality, longer lengths of stay, and higher health care costs. Australia and Great Britain have enacted legislation to prevent patients from spending more than 6 hours in an ED.

Researchers presented their findings at the International Conference on Emergency Medicine in San Francisco, Calif.