Hospitalized patients’ average disability scores were 17 percent higher than scores of patients seen in the ED and sent home, the study found. These hospitalized patients also had the highest risk of nursing home admissions and death. One limitation of the study is that it only included patients insured by one health plan in a small urban area, which may limit how similar the findings would be for people in other parts of the U.S. or with other types of medical coverage, the authors point out.

The study wasn’t a controlled experiment designed to prove whether ED visits or hospital admissions directly cause a decline in functioning for elderly people, or why, the authors also note.

Still the results should be a red flag to watch elderly patients closely when they’re sent home from the ED or the hospital, said Dr. Amy Kelley, a geriatrics researcher at Icahn School of Medicine at Mount Sinai in New York.

“Older adults and their families can do their best to manage chronic health conditions in partnership with their doctors and ask for additional services such as home care or palliative care for symptom management in an attempt to avoid the need for ED visits when possible,” Kelley, who wasn’t involved in the study, said by email.

“After an ED visit, they can work with their healthcare providers to optimize physical function, add needed support at home and continuing discussions to ensure that the individual’s personal priorities are always the true focus of the healthcare plan,” Kelley added.