An Analysis of Emergency Treatment-seeking Characteristics in Elderly Patients in Taiwan in 2010

Huang, Ching-Lin; Cho, Wen-Chin; Tak, Francis Lee Tzen; Choi, Wai-Mau

doi:10.1016/j.ijge.2015.03.001

Cited by 5 publications

(6 citation statements)

References 9 publications

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“…Consistent with the literature in diverse healthcare and regional settings (Anwar et al , 2012; Douthit et al , 2015; Huang et al , 2015), we found that healthcare seeking behaviours varied markedly, depending on multiple factors. In principle, behaviours were predominately driven by affordability.…”

Section: Discussionsupporting

confidence: 89%

Healthcare seeking behaviour among Chinese elderly

Lü

Wang

et al. 2017

IJHCQA

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Purpose The Chinese population is rapidly ageing before they are rich. The purpose of this paper is to describe healthcare seeking behaviour and the critical factors associated with healthcare seeking behaviour. Design/methodology/approach Using a purposive sampling method, the authors recruited 44 adults aged 60 years or older from three provinces, representing the developed (Shanghai), undeveloped (Ningxia) regions and the regions in between (Hubei). From July to September 2008, using a semi-structured guide, the authors interviewed participants in focus group discussions. Findings The healthcare needs for chronic and catastrophic diseases were high; however, the healthcare demands were low and healthcare utilizations were even lower owing to the limited accessibility to healthcare services, particularly, in underdeveloped rural areas. "Too expensive to see a doctor" was a prime complaint, explaining substantial discrepancies between healthcare needs, demands and use. Care seeking behaviour varied depending on insurance availability, perceived performance, particularly hospital services, and prescription medications. Participants consistently rated increasing healthcare accessibility as a high priority, including offering financial aid, and improving service convenience. Improving social security fairness was the first on the elderly's wish list. Originality/value Healthcare demand and use were lower than needs, and were influenced by multiple factors, primarily, service affordability and efficiency, perceived performance and hospital service quality.

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Section: Discussionsupporting

confidence: 89%

Healthcare seeking behaviour among Chinese elderly

Lü

Wang

et al. 2017

IJHCQA

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“…Consistent with prior studies conducted in China, 32 Indonesia 33 and Taiwan, 34 the current study found that older people reported hospitalisation and use of healthcare services more frequently than their younger counterparts. A possible explanation for this finding might be the increasing prevalence of health problems with ageing, which is associated with increased need for healthcare.…”

Section: Discussionsupporting

confidence: 90%

Healthcare-seeking behaviour of marginalised older people in urban slums: a cross-sectional survey study in Khulna City, Bangladesh

et al. 2022

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ObjectivesThis study aimed to measure healthcare-seeking behaviour and determine its associated factors among older people in the slums of the Khulna City Corporation (KCC) areas of Bangladesh.DesignCross-sectional survey.SettingsFour slums in the KCC areas of Bangladesh.ParticipantsThe participants were selected following a two-stage area probability sampling with the following specifications: they must be aged ≥60 years and must have lived in the slums of KCC for at least 5 consecutive years.Outcome measuresA semistructured interview schedule was administered to determine participants’ healthcare-seeking behaviour, with healthcare-seeking behaviour measured through a dichotomous response of ‘yes’ or ‘no’.Results636 participants were included in the study. Gastrointestinal problems (75.3%) and aches and pains (71.5%) were the two most common health problems among older people in the slums of KCC. Older adults in their 80s had higher adjusted odds of attaining healthcare services (adjusted OR (AOR)=2.028; 95% CI: 1.140 to 3.609; p<0.05) than other older people, while educated older people (AOR=0.664; 95% CI: 0.441 to 1.000; p<0.05) and those with greater satisfaction with domains of life (SDL index; AOR=0.860; 95% CI: 0.811 to 0.912; p<0.01) were less inclined to seek healthcare services than their counterparts. Additionally, widows/widowers (AOR=2.218; 95% CI: 1.080 to 4.556; p<0.05) and married people (AOR=2.750; 95% CI: 1.329 to 5.689; p<0.01) had higher adjusted odds of seeking healthcare services than those who were divorced/separated.ConclusionAge, education, marital status and SDL index were significant predictors for the healthcare-seeking behaviour of older people in KCC slums. Effective strategies need to be implemented to reduce existing access barriers to healthcare services for older people in the slum areas of urban Bangladesh.

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“…Consequently, surprisingly high rates of ED visits are made by NH residents 11 . Moreover, these individuals are also more likely to be hospitalized and in need of serious medical attention subsequent to ED visit 12 . As of 2015, approximately 0.8% (23,558 of 2,938,579) of older people aged 65 and over in Taiwan reside in NHs 13 .…”

Section: Introductionmentioning

confidence: 99%

Emergency Department Visits and Disease Burden Attributable to Ambulatory Care Sensitive Conditions in Elderly Adults

Hsieh

Chiang

et al. 2019

Sci Rep

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Many countries worldwide are aging rapidly, and the complex care needs of older adults generate an unprecedented demand for health services. Common reasons for elderly emergency department (ED) visits frequently involve conditions triggered by preventable infections also known as ambulatory care sensitive conditions (ACSCs). This study aims to describe the trend and the associated disease burden attributable to ACSC-related ED visits made by elderly patients and to characterize their ED use by nursing home residence. We designed a population-based ecological study using administrative data on Taiwan EDs between 2002 and 2013. A total of 563,647 ED visits from individuals aged 65 or over were examined. All elderly ED visits due to ACSCs (tuberculosis, upper respiratory infection, pneumonia, sepsis, cellulitis and urinary tract infection (UTI)) were further identified. Subsequent hospital admissions, related deaths after discharge, total health care costs and disability-adjusted life years (DALYs) were compared among different ACSCs. Prevalence of ACSCs was then assessed between nursing home (NH) residents and non-NH residents. Within the 12-year observation period, we find that there was a steady increase in both the rate of ACSC ED visits and the proportion of elderly with a visit. Overall, pneumonia is the most prevalent among six ACSCs for elderly ED visits (2.10%; 2.06 to 2.14), subsequent hospital admissions (5.77%; 5.59 to 5.94) and associated mortality following admission (17.37%; 16.74 to 18.01). UTI is the second prevalent ACSC consistently across ED visits (2.02%; 1.98 to 2.05), subsequent hospital admissions (2.36%, 2.25 to 2.48) and mortality following admission (10.80%; 10.28 to 11.32). Sepsis ranks third highest in the proportion of hospitalization following ED visit (2.29%; 2.18 to 2.41) and related deaths after hospital discharge (7.39%; 6.95 to 7.83), but it accounts for the highest average total health care expenditure (NT$94,595 ± 120,239; ≈US$3185.02) per case. When examining the likelihood of ACSC-attributable ED use, significantly higher odds were observed in NH residents as compared with non-NH residents for: pneumonia (adjusted odds ratio (aOR): 5.01, 95% confidence interval (CI) 4.50–5.58); UTI (aOR: 4.44, 95% CI 3.97–4.98); sepsis (aOR: 3.54, 95% CI 3.06–4.10); and tuberculosis (aOR: 2.44, 95% CI 1.63–3.65). Here we examined the ACSC-related ED care and found that, among the six ACSCs studied, pneumonia, UTI and sepsis were the leading causes of ED visits, subsequent hospital admissions, related mortality, health care costs and DALYs in Taiwanese NH elderly adults. Our findings suggest that efficient monitoring and reinforcing of quality of care in the residential and community setting might substantially reduce the number of preventable elderly ED visits and alleviate strain on the health care system.

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An Analysis of Emergency Treatment-seeking Characteristics in Elderly Patients in Taiwan in 2010

Cited by 5 publications

References 9 publications

Healthcare seeking behaviour among Chinese elderly

Healthcare seeking behaviour among Chinese elderly

Healthcare-seeking behaviour of marginalised older people in urban slums: a cross-sectional survey study in Khulna City, Bangladesh

Emergency Department Visits and Disease Burden Attributable to Ambulatory Care Sensitive Conditions in Elderly Adults

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