title: Old age and chronic disease: is the emergency medical system the appropriate provider for the elderly?
abstract: OBJECTIVE
  The use of emergency medical services increases with the age of patients. Some care providers hold on to the prejudice that these alarms are unnecessary or of a lower importance. We assessed the relation of age and age-dependent emergency characteristics, taking into consideration the ratings of emergency physicians on whether or not emergency cases were considered truly in need of emergency physician attendance.
  
  
  METHODS
  Emergency physicians dispatched by the Berlin Fire Department evaluated for each case the necessity of emergency physician attendance. Case characteristics such as the day of the week and location of the emergency as well as patient characteristics such as age, sex, prior status, and care dependency were recorded. In addition, whether or not the physician accompanied the patient to the hospital was recorded as a parameter for emergency severity. Analysis was performed using multiple logistic regression modeling.
  
  
  RESULTS
  During the 6-month prospective study period, 2702 cases were evaluated. Emergency medical services are used more frequently by older individuals, especially octogenarians. Emergency cases in older individuals were significantly more often rated as in need of emergency physician attendance; however, the rate of patients accompanied by the emergency physician to the hospital did not differ between the age groups. The age of patients, the primary diagnosis, the day and location of the emergency, and the presence of pre-existing dementia showed a significant impact on the necessity of physician-attended emergency missions.
  
  
  CONCLUSIONS
  Despite common prejudices, emergency cases in elder patients are rated more often as in need of emergency physician attendance compared with those involving younger patients.
authors.affiliation: aDepartment of Cardiology and Pneumology, Campus Benjamin Franklin bDepartment of Anesthesiology and Intensive Care Medicine, Campus Charité Mitte and Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Hans-Christian
authors.initials: HC
authors.lastname: Mochmann
authors.forename: Hans-Richard
authors.initials: HR
authors.lastname: Arntz
authors.forename: Falk V
authors.initials: FV
authors.lastname: Dincklage
authors.forename: Ursula
authors.initials: U
authors.lastname: Rauch
authors.forename: Heinz P
authors.initials: HP
authors.lastname: Schultheiss
authors.forename: Peter
authors.initials: P
authors.lastname: Bobbert
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease / Q000628:therapy*; D004630:Emergencies; D004632:Emergency Medical Services / Q000458:organization & administration* / Q000592:standards; D005858:Germany; D006299:Health Services for the Aged / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007223:Infant; D008875:Middle Aged; D011446:Prospective Studies; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D055815:Young Adult