Emergency demand and repeat attendances by older patients. Issue 5 (14th May 2013)

• Record Type: Journal Article
• Authors: Lowthian, J.; Curtis, A.; Stoelwinder, J.; McNeil, J.; Cameron, P.
• Is Part Of: Internal medicine journal. Volume 43:Issue 5(2013)
• Page Start: 554
• Page End: 560
• Publication Date: 2013-05-14
• Subjects: Medicine -- Periodicals; 616
• DOI: 10.1111/imj.12061
• Languages: English
• ISSNs: 1444-0903

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="imj12061-sec-0001" sec-type="section"> <title>Background</title> <p>Population ageing is projected to impact on health services utilisation including Emergency Departments (ED), with older patients reportedly having a high rate of return visits. We describe and compare patterns in ED utilisation between older and younger adults, and quantify the proportion and rate of return visits.</p> </sec> <sec id="imj12061-sec-0002" sec-type="section"> <title>Methods</title> <p>Population‐based retrospective analysis of metropolitan Melbourne public hospital ED data, 1999/2000 to 2008/2009. Numbers of patients, presentations, re‐presentations and rates per 1000 population were calculated, with comparison of older (aged ≥70 years) and younger (15–69 years) attendances.</p> </sec> <sec id="imj12061-sec-0003" sec-type="section"> <title>Results</title> <p>Population growth in each age group was similar over the study period, yet ED presentations rose by 72% for older adults compared with a 59% increase for younger adults. Rates per 1000 population rose with increasing age. Of the population aged ≥70 years, 39% presented to ED compared with 17% of the population aged 15–69 years in 2008/2009. Twenty‐seven per cent of the increase in older adult presentations was driven by a cohort who attended ≥4 times in 2008/2009. The number of older patients presenting ≥4 times doubled over the decade, contributing to 23% of all older presentations in 2008/2009. ED length of stay rose with increasing age; 69% of older adults remained in ED for ≥4 h compared with 39% of younger adults in 2008/2009. The number of older adult ED hospital admissions doubled over the decade.</p> </sec> <sec id="imj12061-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Older patients are disproportionately represented among ED attendances. They also have an increasing propensity to re‐present to ED, indicating a need to identify the clinical, social and health system‐related risk factors for re‐attendance by specific patients.</p> </sec> </abstract>