title: Referral patterns in elderly emergency department visits.
abstract: OBJECTIVE
  To assess elderly individuals' demand for emergency department (ED) care, in terms of the characteristics, processes, outcomes, costs by referral pattern.
  
  
  METHODS
  All ED visits involving patients aged 65 and older, extracted from the 2010 dataset of an Local Health Agency, in North-Eastern Italy (no. = 18 648).
  
  
  METHODS
  Retrospective cohort study.
  
  
  RESULTS
  Patients were referred by primary care professionals (PCPs) in 43.1% of cases, 1.4% came from nursing homes (NH), and 55.5% were self-referred (SR). The SR group had a higher adjusted odds ratio (aOR) for non-urgent conditions (1.98 CI 1.85-2.12), but a lower aOR for conditions amenable to ambulatory care (0.53 CI 0.48-0.59), and a lower consumption of resources. The SR group tend to occur more frequently out of hours, and to coincide with a shorter stay at the ED, lower observation unit activation rates, lower hospitalization rates and a lower consumption of services than other two groups. The average costs for all procedures were lower for the SR patients (mean = 106.04 € ± SD 84.90 €) than for those referred by PCPs (mean = 138.14 € ± SD 101.17 €) or NH (mean = 143.48 € ± SD 95.28 €).
  
  
  CONCLUSIONS
  Elderly patients coming in ED have different characteristics, outcomes and recourses consume by referral pattern.
authors: Dipartimento di Medicina Molecolare, Università degli Studi di Padova, Padua, Italy. E-mail address: alessandra.buja@unipd.it.
authors: Alessandra
authors: A
authors: Buja
authors: Marco
authors: M
authors: Fusco
authors: Patrizia
authors: P
authors: Furlan
authors: Chiara
authors: C
authors: Bertoncello
authors: Tatjana
authors: T
authors: Baldovin
authors: Patrizia
authors: P
authors: Casale
authors: Adriano
authors: A
authors: Marcolongo
authors: Vincenzo
authors: V
authors: Baldo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies