title: Association between age older than 75 years and exceeded target waiting times in the emergency department: a multicenter cross-sectional survey in the Paris metropolitan area, France.
abstract: OBJECTIVE
  We seek to evaluate whether age greater than 75 years is an independent predictor of prolonged waiting time in the emergency department (ED).
  
  
  METHODS
  We retrospectively analyzed all adult attendances to 9 EDs within the Paris area during 2011. The primary endpoint was target waiting time exceeded, defined as a waiting time for medical assessment longer than the maximal recommended waiting time according to triage level. To assess our primary objective, we performed logistic regression using patient- and ED-related variables to determine whether age greater than 75 years was independently associated with higher rate of target waiting time exceeded.
  
  
  RESULTS
  A total of 317,793 patients were included, of whom 173,629 (55%) had an exceeded target waiting time. Mean age was 45.8 years and 12.7% were older than 75 years. Target waiting time was exceeded for 55% of patients: 53% for patients younger than 75 years (95% confidence interval [CI] 53% to 54%) versus 64% for older patients (95% CI 63% to 65%), relative risk 1.20. In the multivariate analysis, age greater than 75 years was independently associated with an exceeded target waiting time (odds ratio [OR] 1.30; 95% CI 1.27 to 1.33). Other variables associated with exceeded target waiting time were triage level (OR 5.45 [95% CI 5.32 to 5.60] for triage level 2 versus triage level 4), high daily occupancy (OR 3.78 [95% CI 3.53 to 4.03]), day of the week (OR 1.12 [95% CI 1.09 to 1.14] for Monday), and time of the visit (OR 1.79 [95% CI 1.76 to 1.82] from 6 pm to 8 am).
  
  
  CONCLUSIONS
  Patients older than 75 years are less likely to be seen within the target waiting time.
authors.affiliation: Emergency Department, Hopital Pitié-Salpetriere, Assistance Publique-Hôpitaux de Paris, Paris, France; Université Pierre et Marie Curie Paris 6, Paris, France. Electronic address: yonathanfreund@gmail.com.
authors.forename: Yonathan
authors.initials: Y
authors.lastname: Freund
authors.affiliation: Emergency Department, Hopital Bicêtre, Assistance Publique-Hôpitaux de Paris, le Kremlin-Bicêtre, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Vincent-Cassy
authors.affiliation: Emergency Department, Royal London Hospital, Barts Health NHS Trust, London, United Kingdom.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Bloom
authors.affiliation: Emergency Department, Hopital Pitié-Salpetriere, Assistance Publique-Hôpitaux de Paris, Paris, France; Université Pierre et Marie Curie Paris 6, Paris, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Riou
authors.affiliation: Emergency Department, Hopital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France; Université Pierre et Marie Curie Paris 6, Paris, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Ray
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001509:Bed Occupancy; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010297:Paris; D012189:Retrospective Studies; D013997:Time Factors; D014218:Triage; D014850:Waiting Lists