diagnosed rates of complex chronic diseases (diabetes, hypertension, glaucoma asthma), and lower rates of less complicated chronic diseases (hypothyroidism, atrial fibrillation, cataracts) than older White adults living in the same community. Within-community racial disparities and between-community disparities within race groups were jointly examined for diabetes and hypertension, common targets of evidencebased interventions. Results suggest that different intervention strategies may be

more »

... in communities depending upon not only chronic disease prevalence rates, but also the degree of within-community racial disparities. Emergency departments (EDs) remain a major care delivery site for older adults (>65 years) representing nearly 20 million of 130 million visits in 2010. With the older adult population increasing from 40.4 million in 2010 to 55.0 million by 2020, EDs will be challenged to provide quality care to patients presenting with co-morbid conditions, polypharmacy, decreased functional reserve, and atypical symptomology. The new geriatric emergency department (GED) care model is a response to this situation and has been implemented in over 90 hospital EDs nationwide.This study used mixed-methods (survey & participant observation) to analyze current GEDs based on the set of GED guidelines jointly issued in February 2014 by four major emergency medicine/ geriatric professional societies. Research results suggest heterogeneous compliance with the guidelines in the domains of 1) GED physical environment; 2) GED staffing and training levels; and, 3) GED policies & procedures. Survey data documents fewer than 20% of EDs built separate physical GEDs. Yet, over 95% report some physical environment changes (e.g. mattresses, flooring, lighting); some level of enhanced staff training (e.g., on-line courses); and some procedure changes (e.g., 24 hour patient call backs). Furthermore, the reported survey results contrasted sharply with the participant-observation and staff interviews in a subset of six GEDs. The qualitative findings illuminated how survey data may incompletely represent the actual meaning of GED implementation from ED staff perspectives. Clinicians and policy makers will need to address issues of validity in ongoing measurement of GEDs and associated patient outcomes. Background: Hospitalization among older people is common and associated with risk of adverse outcomes such as iatrogenic disorders and physical impairments. Knowledge about personal characteristics and social factors related to hospitalization is scarce. In order to understand which factors that are related to hospitalization risk, a prospective study with a multifactorial approach was conducted. Methods: In 2003, 794 Swedish persons (mean age 70.1 years, 60.7% females) answered a postal questionnaire as a part of the population-based longitudinal Swedish Adoption/Twin Study of Aging (SATSA). Participants were asked about physiological and psychological health, personality and socio economic factors. During seven years of follow-up, information on hospitalizations and the associated diagnoses were obtained from the Swedish National Inpatient Register. Results: Preliminary results show that 484 persons (61.0%) had at least one hospital admission during the follow-up period. The most common causes of admission were cardiovascular diseases and tumors. Cox proportional hazard regression model controlling for age, sex and dependency within twin pairs, showed that higher locus of control (HR=0.89, 95% CI=0.83-0.96), marital