[Emergency admission of eighty year-old and older patients. Characteristics and health care channels].
OBJECTIVE
The primary objective of this study was to describe characteristics and health channels of all octogenarians admitted during a 12 weeks period from two emergency units (EU) (A and B). To do so, an investigator collected data from each EU from the patients and medical teams. The secondary objective was to compare health channels between the two EU. In contrast with EU B, EU A had developed a formal cooperation with Geriatrics units. For comparison between the EU, the chi 2 and Student's t tests were used. For description of health channels, we used the following definitions: transfer: the patient was admitted after his admission to an EU in another hospital and inadequate orientation: patients in whom the diagnosis exceeded the specialty department to which they had been admitted.


RESULTS
A mean of 3.4 elderly patients/day aged 80 years and more were admitted in emergency. Most patients had initially been admitted to the EU. Length of stay in the EU was > 2 days in 26.5% of cases. To be able to cope with this flow of patients, the EU had organised health channels depending on local capacity and without the influence of the formal cooperation: in EU A, the transfer rate was of 51%; in EU B, transfers were less frequent (18%, p < 0.0001) but the proportion of inadequate orientation was of 39.4% vs. 22.7% in EU A (p = 0.02). The rate of admission to a geriatric unit was identical (13%).


CONCLUSIONS
Health channels of elderly patients admitted in emergency exhibit dysfunctions: frequent transfers, prolonged length of stay in an EU, inadequation. A formal cooperation between the EU and Geriatrics units is not sufficient to lastingly improve health care channels.
Somme
Dominique
D
Service de gériatrie, Hôpital Européen Georges-Pompidou, 20 rue Leblanc 75015 Paris. dominique.somme@hop.egp.ap-hop-paris.fr
Yvain
Fabienne
F
Levy
Albert
A
Ellrodt
Axel
A
Davido
Alain
A
St-Jean
Olivier
O
D000368:Aged; D000369:Aged, 80 and over / Q000706:statistics & numerical data*; D003266:Continuity of Patient Care; D003631:Day Care, Medical / Q000458:organization & administration; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005853:Geriatrics / Q000458:organization & administration; D006302:Health Services Research; D006299:Health Services for the Aged / Q000458:organization & administration*; D006801:Humans; D020380:Needs Assessment / Q000458:organization & administration; D010297:Paris; D010343:Patient Admission / Q000706:statistics & numerical data*; D010360:Patient Transfer / Q000706:statistics & numerical data