Utilization of emergency center services by older adults with a psychiatric diagnosis.
Information regarding older adult emergency center (EC) patient characteristics remains limited, despite its increasing importance in health care delivery systems. This retrospective study encompasses all EC visits over an eight-year period (n = 825,682) to a large urban county hospital. Only participants with a primary psychiatric diagnosis were examined, and included a total of 53,894 adults, 18-64 years old and 1,478 adults, > or =65 years old. Despite an increasing aging population, EC visits for older adults with psychiatric disorders did not increase over time. Within the older adult sample, cognitive, psychotic, and bipolar disorders were associated with higher rates of admission to the hospital, while substance use, depressive, and anxiety disorders were associated with lower numbers of inpatient admissions. African-Americans were over-represented in the EC and admitted to the hospital at higher rates, compared to other ethnic groups. Caucasian patients were the group most frequently diagnosed with a substance use disorder. In conclusion, differences in race, and diagnosis support the idea that such variables directly relate to utilization rates, presentation, and disposition within the EC.
Cully
J A
JA
Houston Center for Quality of Care and Utilization Studies, Veterans Affairs HSR&D Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Baylor College of Medicine, Houston, TX, USA. jcully@bcm.tmc.edu
Molinari
V A
VA
Snow
A L
AL
Burruss
J
J
Kotrla
K J
KJ
Kunik
M E
ME
D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology / Q000534:rehabilitation; D001714:Bipolar Disorder / Q000453:epidemiology / Q000534:rehabilitation; D003072:Cognition Disorders / Q000453:epidemiology / Q000534:rehabilitation; D003866:Depressive Disorder / Q000453:epidemiology / Q000534:rehabilitation; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D008875:Middle Aged; D011618:Psychotic Disorders / Q000453:epidemiology / Q000534:rehabilitation; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation