Emergency medical transport of the elderly

Wofford, James L.; Moran, William P.; Heuser, Markus; Schwartz, Earl; Vélez, Ramón; Mittelmark, Maurice B.

doi:10.1016/0735-6757(95)90203-1

Cited by 60 publications

(51 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…American researchers Gerson and Shvarch, 20 McConnel and Wilson 21 and Rucker et al 22 identified patients aged 65 years were almost twice as likely to use emergency ambulances compared with those <65 years, with a concomitant incremental increase in usage from 65 to 85+ years of age. 23 Australian and British studies found a similar association in the late 1990s. 10,11 Review of London Ambulance Service's workload at that time showed consistently high rates for patients greater than 75 years old over a 10-year period.…”

Section: Population Growth and Ageingsupporting

confidence: 50%

Increasing utilisation of emergency ambulances

Lowthian¹,

Cameron²,

Stoelwinder³

et al. 2011

Aust. Health Review

188

161

View full text Add to dashboard Cite

Background. Increased ambulance utilisation is closely linked with Emergency Department (ED) attendances. Pressures on hospital systems are widely acknowledged with ED overcrowding reported regularly in the media and peer-reviewed literature. Strains on ambulance services are less well-documented or studied.Aims. To review the literature to determine the trends in utilisation of emergency ambulances throughout the developed world and to discuss the major underlying drivers perceived as contributing to this increase.Method. A search of online databases, search engines, peer-reviewed journals and audit reports was undertaken. Findings. Ambulance utilisation has increased in many developed countries over the past 20 years. Annual growth rates throughout Australia and the United Kingdom are similar. Population ageing, changes in social support, accessibility and pricing, and increasing community health awareness have been proposed as associated factors. As the extent of their contribution has not yet been established these factors were reviewed.Conclusion. The continued rise in utilisation of emergency ambulances is placing increasing demands on ambulance services and the wider health system, potentially compromising access, quality, safety and outcomes. A variety of factors may contribute to this increase and targeted strategies to reduce utilisation will require an accurate identification of the major drivers of demand.What is known about the topic? Ambulance utilisation is increasing annually throughout the developed world, with previous research suggesting numerous underlying factors. What does this paper add? These factors have not been previously synthesised in the international literature. This narrative review clearly articulates the underlying problems. What are the implications for practitioners? This paper outlines the need for further research of the causes of increased emergency ambulance utilisation, to enable the development of appropriate strategies to manage demand in the future.

show abstract

Section: Population Growth and Ageingsupporting

confidence: 50%

Increasing utilisation of emergency ambulances

Lowthian¹,

Cameron²,

Stoelwinder³

et al. 2011

Aust. Health Review

188

161

View full text Add to dashboard Cite

show abstract

“…1 The association between older age and increased frequency of EMS use as a mode of transportation to the emergency department (ED) compared to younger adults is well-documented. [4][5][6][7][8][9][10][11][12][13][14][15] Among ED patients, older age has been associated with an increase in perceived medical necessity, 16 injury or illness severity, 12,16 poor social and physical function, 16 comorbidities, 8 and insurance status, all of which may lead to increased EMS use. 4,12,13 Previous research studies evaluating the effect of older age on transportation to an ED via an ambulance have been retrospective, have not collected the breadth of information necessary for a complete analysis, have not used statistical methods to control for potential confounding variables, or have been performed in unique sub-populations.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Older Age on EMS Use for Transportation to an Emergency Department

Jones

Wasserman

et al. 2017

Prehosp. Disaster med.

View full text Add to dashboard Cite

Introduction: Previous studies have found that older adults are more likely to use Emergency Medical Services (EMS) than younger adults, but the reasons for this remain understudied. Hypothesis/Problem: This study aimed to determine if older age is associated with using EMS for transportation to an emergency department (ED) after controlling for confounding variables. Methods: A cross-sectional survey study was conducted at a large academic medical center. Data on previous medical history, chief complaint, self-perceived illness severity, demographic information, and mode of arrival to the ED were collected on all subjects. Those who arrived to the ED via EMS also were asked reasons why they opted to call an ambulance for their illness/injury. Descriptive statistics were used to quantify survey responses, and multivariable regression was used to assess the independent effect of age on mode of ED arrival. Results: Data from 1,058 subjects were analyzed, 449 (42%) of whom arrived to the ED via EMS. Compared to adults <55 years, the unadjusted prevalence ratio for the association between age and EMS use was 1.18 (95% CI, 0.96-1.45) for subjects 55-79 years and 1.54 (95% CI, 1.18-2.02) for subjects ≥80 years. After adjustment for confounding variables, age remained a statistically significant risk factor for EMS use (P < .05). Conclusion: Older age is an independent risk factor for transportation to the ED via ambulance; however, this effect is attenuated by number of chronic medical conditions and history of depression. Additional research is needed to account for confounders unmeasured in this study and to elucidate reasons for the increased frequency of EMS use among older adults.Jones CMC, Wasserman EB, Li T, Amidon A, Abbott M, Shah MN. The effect of older age on EMS use for transportation to an emergency department. Prehosp Disaster Med. 2017;32(3):261-268. IntroductionIt is estimated that 38% of all ambulance transports are for adults aged 65 or older, despite only comprising 13% of the population.1,2 The size of the older adult population is growing. By the year 2050, it is estimated that there will be over 84 million adults 65 years of age and older in the United States.3 This increase in the older adult population has the potential to place strains on the ambulance-based Emergency Medical Services (EMS) system as the rate of EMS utilization among older adults is nearly four-times higher than adults less than age 65 (167 per 1,000 versus 39 per 1,000).

show abstract

“…A number of studies have shown that elders access emergency medical services (EMS) care significantly more frequently than younger individuals, with a rate of approximately 70 incidents/1,000 population for the overall population, approximately 100 incidents/1,000 population for individuals aged 65-74 years, and approximately 200 incidents/1,000 population for individuals more than 85 years old. [2][3][4][5] The combination of the growing elder population and the higher utilization rates will place EMS services in greater demand in the years to come, thus requiring greater expenditures by communities with limited funds.…”

mentioning

confidence: 99%

Predictors of Emergency Medical Services Utilization by Elders

Shah

2003

Academic Emergency Medicine

View full text Add to dashboard Cite

Objective: Elders (age Ն 65 years) frequently use emergency medical services (EMS) for care. Understanding reasons for EMS use by elders may allow better management of EMS demand. To the best of the authors' knowledge, no studies have identified patient characteristics associated with EMS use by elders. This study aimed to identify patient attributes associated with elder EMS users. Methods: This was a prospective cohort study of non-institutionalized elders presenting to an urban university hospital emergency department. Nine hundred thirty elder patients completed the survey. The authors asked patients about access to care, health beliefs, and reasons for requesting EMS assistance. Univariate and logistic regression were used to identify predictors of EMS use. Results: The sample had a mean age of 76 years; 37% were male; 79% were African American. Thirty percent arrived via EMS. Sixty-five percent of those transported and 46% of those not transported by EMS were admitted to the hospital (p < 0.001). Reported reasons for using EMS transport included immobility (33%), illness (22%), request by others (21%), instruction from health care providers (10%), and lack of transportation (10%). Logistic regression identified symptom onset within four hours of seeking care (OR = 3.1), age Ն 85 years (OR = 1.63), increased deficiencies in activities of daily living (OR = 1.40 per deficiency), worse physical functioning (OR = 1.14/10 points), and worse social functioning (OR = 1.06/10 points) as factors associated with EMS use. Conclusions: Elders report using EMS because of immobility, perceived medical needs, or requests by others. Similarly, the presence of acute illness symptoms, older age, and poor social and physical function, rather than health beliefs, predict EMS use among elders. These factors must be considered when managing the demand for EMS services. shown that elders access emergency medical services (EMS) care significantly more frequently than younger individuals, with a rate of approximately 70 incidents/1,000 population for the overall population, approximately 100 incidents/1,000 population for individuals aged 65-74 years, and approximately 200 incidents/1,000 population for individuals more than 85 years old.2-5 The combination of the growing elder population and the higher utilization rates will place EMS services in greater demand in the years to come, thus requiring greater expenditures by communities with limited funds.One approach to the problem of increasing EMS volume is to understand and then intervene upon the reasons elder patients access the EMS system. By intervening upon the modifiable factors that stimulate demand for EMS, clinicians, administrators, and public health planners may be able to better manage the demand for EMS services. However, we have not found any studies that performed detailed evaluations of reasons for elder use of EMS. Previous studies examining EMS use by elders have primarily described the epidemiology of injuries in elder patients, 2,6 compared young EMS

show abstract

Emergency medical transport of the elderly

Cited by 60 publications

References 14 publications

Increasing utilisation of emergency ambulances

Increasing utilisation of emergency ambulances

The Effect of Older Age on EMS Use for Transportation to an Emergency Department

Predictors of Emergency Medical Services Utilization by Elders

Contact Info

Product

Resources

About