Emergency department utilization by the elderly: analysis of the National Hospital Ambulatory Medical Care Survey.
OBJECTIVE
To characterize the ED utilization patterns of the elderly population using nationally representative data.


METHODS
A secondary analysis was performed using the National Hospital Ambulatory Medical Care Survey (NHAMCS), a nationwide, stratified probability sample of ED encounters. Using these physician-reported data, the demographics, patient complaints, physician diagnoses, and dispositions were compared by age group, i.e., young-old (age 65-84 years) vs old-old (age > or = 85 years).


RESULTS
The elderly (age > or = 65 years) represented 5,038 (19.6%) of 25,646 ED encounters for all adults (age > or = 18 years). The geriatric age groups (ages 65-74, 75-84, and > or = 85 years) accounted for 45.3%, 37.4%, and 17.2% of all the encounters by the elderly. The proportions of female patients and white patients were higher with increasing age. The proportion of elderly patients hospitalized was 4 times that of younger adults and reflected monotonic increase with increasing age among elders. Patient complaints and physician diagnoses were generally similar for the young-old (65-84 years) and the old-old (> or = 85 years).


CONCLUSIONS
These findings are consistent with previous single-center studies of geriatric ED patients. This data source may be useful for investigation of clinical issues related to the care of elderly ED patients.
Wofford
J L
JL
Wake Forest University, Bowman Gray School of Medicine, Department of Internal Medicine, Winston-Salam, NC 27157, USA. jwofford@isnet.is.wfu.edu
Schwartz
E
E
Timerding
B L
BL
Folmar
S
S
Ellis
S D
SD
Messick
C H
CH
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D003625:Data Collection; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D014481:United States