title: Geriatric patient emergency visits. Part II: Perceptions of visits by geriatric and younger patients.
abstract: OBJECTIVE
  To compare group perceptions of reasons for emergency department care, ED use patterns, and the effect of illness on self-care ability for elderly and younger adult patients.
  
  
  METHODS
  Patient survey.
  
  
  METHODS
  Six geographically distinct US hospital EDs.
  
  
  METHODS
  From each site, a stratified sample (approximately 7:3) of elderly (65 years and older) and nonelderly (21 to 64 years old) control ED patients treated during the same time period was contacted.
  
  
  METHODS
  Three hundred ninety-nine elderly patients and 172 adult controls were interviewed using a structured survey instrument. Groups were compared using chi 2 analysis and the Mann-Whitney U test.
  
  
  RESULTS
  Both the elderly and the control patients (49% versus 38%) commonly stated that the most important reason for coming to the ED was because they were "too sick to wait for an office visit." Of patients with a regular physician, both groups often were referred to the ED by their primary care provider (35% versus 26%). While the elderly had more visits to their primary care provider (3.3 versus 2.9 visits; P less than .00001), there was no difference in the number of ED visits (1.5 versus 1.6 visits) during the preceding six months. Of those released from the ED, more elderly noted deterioration in their ability to care for themselves as a result of their illness (21% versus 11%; P less than .03).
  
  
  CONCLUSIONS
  The elderly use the ED for reasons similar to those for younger adults. Often they feel too ill to wait for an office visit or are referred in by their primary care provider. Elderly patients more commonly have difficulty with self care after release home, and emergency physicians must plan accordingly.
authors.affiliation: Oregon Health Sciences University, Portland.
authors.forename: J R
authors.initials: JR
authors.lastname: Hedges
authors.forename: B M
authors.initials: BM
authors.lastname: Singal
authors.forename: E W
authors.initials: EW
authors.lastname: Rousseau
authors.forename: A B
authors.initials: AB
authors.lastname: Sanders
authors.forename: E
authors.initials: E
authors.lastname: Bernstein
authors.forename: R M
authors.initials: RM
authors.lastname: McNamara
authors.forename: T M
authors.initials: TM
authors.lastname: Hogan
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003266:Continuity of Patient Care; D003710:Demography; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data; D010351:Patient Discharge; D012017:Referral and Consultation; D012648:Self Care