title: Utilization of the emergency department by older residents in Kuala Lumpur, Malaysia.
abstract: OBJECTIVE
  To determine the pattern of utilization of emergency department (ED) services by older patients in Kuala Lumpur, Malaysia, compared with younger patients in the same setting.
  
  
  METHODS
  The sociodemographics, clinical characteristics and resource utilization of consecutive patients attending the adult ED at the University Malaya Medical Center were recorded during a typical week.
  
  
  RESULTS
  A total of 1649 patients were included in the study; 422/1649 (25.6%) were aged ≥60 years and 1077 (74.4%) were aged <60 years. Older adult patients were more likely to be diagnosed with ischemic heart disease (12.6% vs 2.5%, P < 0.001), and more likely to require investigations such as electrocardiogram (68.1% vs 16.6%, P < 0.001) or chest X-rays (67.6% vs 24.0%, P < 0.001) than their younger counterparts. Logistic regression methods showed that older adults remained an independent predictor of hospital admission (OR 2.75, 95% CI 2.11-3.57).
  
  
  CONCLUSIONS
  The ratio of older adult patients attending our ED over the proportion of older people in the general population was 26:6, which is far higher than reported in previous published studies carried out in other countries. Older ED attenders are also more likely to require investigations, procedures and hospital admissions. With the rapidly aging population in Malaysia, reconfiguration of resources will need to occur at a compatible rate in order to ensure that the healthcare needs of our older adults are met.
authors.affiliation: Faculty of Medicine, MARA University of Technology, Batu Caves, Selangor Darul Ehsan, Malaysia.
authors.forename: Mohd Amin
authors.initials: MA
authors.lastname: Mohd Mokhtar
authors.affiliation: Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Tan Maw
authors.initials: TM
authors.lastname: Pin
authors.affiliation: Academic Unit of Trauma and Emergency Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Mohd Idzwan
authors.initials: MI
authors.lastname: Zakaria
authors.affiliation: Julius Center University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Noran Naqiah
authors.initials: NN
authors.lastname: Hairi
authors.affiliation: Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Shahrul Bahiyah
authors.initials: SB
authors.lastname: Kamaruzzaman
authors.affiliation: Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Chin Ai
authors.initials: CA
authors.lastname: Vyrn
authors.affiliation: Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Philip Poi Jun
authors.initials: PP
authors.lastname: Hua
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D003430:Cross-Sectional Studies; D003906:Developing Countries; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006295:Health Resources / Q000191:economics*; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D014505:Urban Population
keywords: admission; elderly; emergency department attendances; investigations; procedures