title: Determinants of recourse to hospital treatment in the elderly.
abstract: BACKGROUND
  All over Europe, an increased use of public health services has been noticed, particularly referring to access and hospitalization among elderly in the emergency department (ED).
  
  
  METHODS
  Prospective study at a university teaching hospital in Turin, northern Italy, recruiting subjects aged >65 years consecutively attending the medical ED during 1 month. Demography, functional and cognitive status, comorbidity, severity of acute critical illness, previous ED accesses and hospitalization, diagnosis and other relevant data for ED admission and hospitalization were considered.
  
  
  RESULTS
  Data were collected for 1632 patients (average age 77.6 years), 89% of the 1834 older subjects who attended the ED during the study period (29.3% of the patients attending the ED). Six hundred and fifty older subjects were admitted to the hospital (62.2% of the hospital admissions). Severity of acute critical illness, presence of chronic obstructive pulmonary disease and heart failure, a high number of drugs being taken, functional dependence and advanced age were independently associated with hospital admission. One-third of the patients appeared to be frequent users of health services with more than two visits/admissions. Higher comorbidity, partial or complete functional dependence, chronic diseases (arrhythmia, pulmonary neoplasm, diseases of the large intestine) and politherapy were associated either with frequent use of the ED and multiple admissions.
  
  
  CONCLUSIONS
  Elderly account for a high proportion of hospitalizations, mainly determined by critical health conditions, advanced age and functional dependence. Poor health conditions (high comorbidity and presence of chronic multi-organ diseases), functional dependence but not critical social factors were the main determinants of multiple hospital admissions.
authors: SCDU Geriatria e Malattie Metaboliche dell'Osso, Torino, Italia.
authors: Alessandro
authors: A
authors: Sona
authors: Guido
authors: G
authors: Maggiani
authors: Marco
authors: M
authors: Astengo
authors: Monica
authors: M
authors: Comba
authors: Valentina
authors: V
authors: Chiusano
authors: Gianluca
authors: G
authors: Isaia
authors: Chiara
authors: C
authors: Merlo
authors: Larisa
authors: L
authors: Pricop
authors: Eleonora
authors: E
authors: Quagliotti
authors: Corrado
authors: C
authors: Moiraghi
authors: Gianfranco
authors: G
authors: Fonte
authors: Mario
authors: M
authors: Bo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy; D008297:Male; D011446:Prospective Studies