The Sherbrooke Questionnaire predicts use of emergency services

Background: the National Service Framework for Older People mandates the introduction of ‘intermediate care services’ to reduce emergency admissions to hospital from the population aged 75 years or more. We evaluated the predictive performance of one of the screening instruments used to identify older people who might most benefit from such services.

Methods: using multiple logistic regression, we compared responses to the six-item, self-administered Sherbrooke Questionnaire with subsequent patterns of emergency attendance and admission to hospital among the elderly population of one borough in West London.

Results: excess risk of both emergency attendance and admission became significant when two or more risk factors were present, and rose progressively with each additional factor, regardless of their nature. With each additional year of age, risks of emergency attendance and admission to hospital increased by 8% (95% CI = 6–10) and 9% (95% CI = 7–12), respectively. There were also significant independent risks associated with reporting memory problems (typical odds ratio (OR) 1.41, 95% CI = 1.14–1.75) and taking three or more medications (OR 1.65, 95% CI = 1.34–2.02), as well as large risks associated with attendance or admission in the year before screening.

Conclusion: the Sherbrooke Questionnaire is a good measure of likely need for emergency visits to hospital among the elderly. However, programmes attempting to reduce such events should also take into account the individual’s recent history of emergency attendance at hospital.