Emergency department visits in older patients: a population-based survey

Abstract

Background Given the higher incidence of emergency conditions in older inhabitants, the global increase in aged population will pose a challenge for emergency services. In this study we examined the burden caused to emergency health care by the aged population. Methods Consecutive patients aged 80 years or over visiting a high-volume, collaborative emergency department (ED) between 2015 and 2016 were included. The key factors under analysis were the incidence of emergency conditions and costs associated with emergency care. Results A total of 6944 patients (median age 85 years, range 80–104 years; 67% female) aged ≥80 years representing 1.5% of the local population, made 17,769 ED visits during the two-year observation period accounting for 15% of all ED visits. Forty-two percent ( n = 2884) of patients had a single ED visit, whereas 8.2% ( n = 570) made ≥5 ED visits/year for a total of 1400 visits (7.9%). Thirty-two percent of those aged ≥80 years required ED services each year. The number of ED visits increased with age ( p < 0.001); and was 768/1000 person-years among octogenarians and 1007/1000 among nonagenarians, in comparison to 233/1000 among those aged < 80 years. One in five of the study population were discharged with non-specific diagnoses. Typical diagnoses included pneumonia (4.8%), malaise and fatigue (4.5%) and heart failure (4.3%). Non-specific diagnoses were frequent, and examination of patients with non-specific diagnoses incurred costs similar to or higher than those of other patients. The mean cost per ED visit in older patients was 422 €. Conclusions We demonstrated a high incidence of emergency department visits in older patients. While our aim was not to solve how the growing demand should be met, it seems unlikely that increasing ED resources is feasible. Instead, the focus should be on chronic care of the aged and prevention of potentially avoidable ED visits.

The Frequency of Utilization of X-Rays in Emergency Department of King Talal Military Hospital

“…However, other studies conducted in western countries showed that females were more likely to visit emergency departments compared with male, and agree with our findings that older patients were likely to visit emergency departments [9][10][11][12][13] . The explanation for variations in predominance of males in our study compared with other studies may due to the nature of structure of our community in which males are more engaged in public activities and employment, particularly in military services.…”

Profile of geriatric presentations at the emergency department of a rural district hospital in South Africa

“…This is consistent with findings by Ukkonen et al . (2019) [ 41 ]. Further findings by this present study, which show that 48.3% (n=143) and 36.1% (n=107) of the patients were admitted for further management and discharged from the ED, respectively suggests that the levels of medical conditions of the majority of elderly patients who visited the BDH ED were mild to moderate.…”

Can dedicated emergency team and area for older people reduce the hospital admission rate? - An observational pre- and post-intervention study

“…The care of older patients in the emergency department (ED) is often complex due to comorbidity, polypharmacy [1], cognitive and functional decline. In addition, older patients are frequent visitors who often present atypical symptoms, require more extensive diagnostic workup, stay longer in the ED, and are more often admitted to inpatient care [2][3][4][5]. Research on innovative care models for older ED patients is therefore a high priority [6].…”