title: ED use by older victims of family violence.
abstract: OBJECTIVE
  To determine the nature and frequency of ED use by victims of physical elder abuse.
  
  
  METHODS
  Community-dwelling victims of abuse were identified through a state elderly protective service program independent of the health care system in a geographic area served by two EDs. ED records were reviewed and abstracted to determine if and how victims used emergency services.
  
  
  RESULTS
  During a 7-year period, 182 elderly victims of physical abuse were identified in the catchment area of the study, and 114 (62.6%) had been seen in one or both EDs at least once during a 5-year "window" surrounding the initial identification of abuse. These 114 individuals accounted for 628 visits (median 3, range 1-46); 30.6% of visits resulted in a hospital admission. An ordinal system was used that assigned a probability of any single ED visit being referable to abuse; 37.8% of subjects had at least one visit categorized as being of high probability, and 66% of subjects had at least one visit that resulted in an injury-related chief symptom or ICD-9 discharge diagnosis.
  
  
  CONCLUSIONS
  Elder abuse victims have substantial interactions with EDs and these visits frequently result in admission. Strategies that identify elder abuse in less acute settings and effectively address the needs of victims would improve quality of life and likely result in substantial savings in health care expenditures.
authors.affiliation: Department of Medicine, New York Hospital-Cornell Medical Center, New York, USA. alagappa@lij.edu
authors.forename: M S
authors.initials: MS
authors.lastname: Lachs
authors.forename: C S
authors.initials: CS
authors.lastname: Williams
authors.forename: S
authors.initials: S
authors.lastname: O'Brien
authors.forename: L
authors.initials: L
authors.lastname: Hurst
authors.forename: A
authors.initials: A
authors.lastname: Kossack
authors.forename: A
authors.initials: A
authors.lastname: Siegal
authors.forename: M E
authors.initials: ME
authors.lastname: Tinetti
mesh_terms: D000368:Aged; D002391:Catchment Area, Health; D003237:Connecticut; D004552:Elder Abuse / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005190:Family; D005260:Female; D006801:Humans; D008297:Male