Elderly attenders have a higher 30-day mortality risk compared to the overall ED population, with mortality risk more marked for frequent attenders. This study illustrates the importance and need for interventions to address frequent ED visits by the elderly, especially in an aging society.

BACKGROUND:To determine if elderly frequent attenders are associated with increased 30-day mortality, assess resource utilization by the elderly frequent attenders and identify associated characteristics that contribute to mortality. METHODS:Retrospective observational study of electronic clinical records of all emergency department (ED) visits over a 10-year period to an urban tertiary general hospital in Singapore. Patients aged 65 years and older, with 3 or more visits within a calendar year were identified. Outcomes measured include 30-day mortality, admission rate, admission diagnosis and duration spent at ED. Chi-square-tests were used to assess categorical factors and Student t-test was used to assess continuous variables on their association with being a frequent attender. Univariate and multivariate logistic regressions were conducted on all significant independent factors on to the outcome variable (30-day mortality), to determine factor independent odds ratios of being a frequent attender.RESULTS: 1.381 million attendance records were analyzed. Elderly patients accounted for 25.5% of all attendances, of which 31.3% are frequent attenders. Their 30-day mortality rate increased from 4.0% in the first visit, to 8.8% in the third visit, peaking at 10.2% in the sixth visit. Factors associated with mortality include patients with neoplasms, ambulance utilization, male gender and having attended the ED the previous year.CONCLUSION: Elderly attenders have a higher 30-day mortality risk compared to the overall ED population, with mortality risk more marked for frequent attenders. This study illustrates the importance and need for interventions to address frequent ED visits by the elderly, especially in an aging society.

gaps, and key recommendations supporting NATO's fundamental security tasks. Conclusion: Recommendations for humanitarian and governmental actors with focus on efficiency and interagency coordination, based on detailed epidemiological information, can decrease morbidity and mortality for the conflict in Ukraine. Study/Objective: We aim to discuss how a simple implementation of a basic electronic health records system has helped to improve efficiency and patient safety for humanitarian aid within a rural setting. Background: Humanitarian aid involves the challenge of delivering health care within a resource-limited setting, often dealing with cultural and language barriers. To bridge the cultural and language gap, and to keep proper medical records of patients served within a rural setting, we designed a low-cost electronic health records system with accessible components. Methods: To help create a sustainable method for a humanitarian aid effort in Cambodia to keep track of patients' medical records, we created a simple user-friendly program interface which allows entry of basic medical information, including location of consult, consultation notes, past medical history, and medications prescribed for multiple patients. To accurately match patients with their medical records and proper patient identification, we employed the use of a simple biometric system. We used a dual authentication method, comprising of a simple off-the-shelf fingerprint scanner with a digital camera for photograph taking for facial recognition. Results: There was positive feedback on the performance of the electronic health record system and its biometric functionality. The system was able to function effectively and cope with the high flow of patients at clinics. The system also led to more efficient medical record keeping and retrieval, with a decrease in manual paperwork. We envision the system to be further improved with time to increase functionality and to remain as a viable low-cost alternative to efficient medical record keeping and retrieval for humanitarian aid in the rural setting. (If selected for presentation, pictures of the EHR and it's implementation would be provided). Conclusion: Utilization of basic and cost effective technology for electronic health records and biometric recognition of patients is possible and helps the provision of medical humanitarian aid in a low-cost setting.