title: Older adults in Emergency Department: management by clinical severity at triage.
abstract: BACKGROUND
  The elderly are involved in an ever-increasing proportion of Emergency Department (ED) visits, consuming a large share of the available resources. The aim of this study was to assess elderly individuals' demand for ED hospital care, in terms of the management process and outcomes by level of urgency at triage.
  
  
  METHODS
  The design was a retrospective cohort study. Details on ED attendance were drawn from the 2010 dataset of the Local Health Agency n°18 (n=18,648) in the Veneto Region, North-East Italy and the participants were resident seniors seen at the ED aged 65 or more.
  
  
  RESULTS
  At triage on arrival, their priority was most often (in 38.63% of cases) considered non-urgent (white triage tag - Wt). In the majority of these cases, the elderly patients were self-referred, although about 1 in 5 of them had been referred by their General Practitioners. The consumption of resources for specialist visit and routine X-rays is higher for non-urgent patients. Injuries, requests for specialist examinations and musculoskeletal disorders account for a large proportion of the reasons why elderly people classified as Wt at triage had gone to the ED.
  
  
  CONCLUSIONS
  Our findings show that older patients have high rates of non-urgent ED attendance, especially for minor traumatic events or requests to see a specialist. This picture emphasizes the need to develop new organizational models for delivering care to meet the most common health care needs of this special frail population.
authors.affiliation: M. Fusco is MD, School of Hygiene and Preventive Medicine, Department of Molecular Medicine, Section of Public Health, Laboratory of Public Health and Population Studies, University of Padua.
authors.forename: M
authors.initials: M
authors.lastname: Fusco
authors.affiliation: A. Buja is PhD, P. Furlan is SD, T. Baldovin is BS and PhD, C. Bertoncello is MD and PhD and V. Baldo is Full Professor, Department of Molecular Medicine, Section of Public Health, Laboratory of Public Health and Population Studies, University of Padua.
authors.forename: A
authors.initials: A
authors.lastname: Buja
authors.affiliation: A. Buja is PhD, P. Furlan is SD, T. Baldovin is BS and PhD, C. Bertoncello is MD and PhD and V. Baldo is Full Professor, Department of Molecular Medicine, Section of Public Health, Laboratory of Public Health and Population Studies, University of Padua.
authors.forename: P
authors.initials: P
authors.lastname: Furlan
authors.affiliation: P. Casale is SD, Azienda ULSS 18 Rovigo, Region Veneto.
authors.forename: P
authors.initials: P
authors.lastname: Casale
authors.affiliation: A. Marcolongo is MD and Regional Director of Health, Friuli Venezia Giulia Region.
authors.forename: A
authors.initials: A
authors.lastname: Marcolongo
authors.affiliation: A. Buja is PhD, P. Furlan is SD, T. Baldovin is BS and PhD, C. Bertoncello is MD and PhD and V. Baldo is Full Professor, Department of Molecular Medicine, Section of Public Health, Laboratory of Public Health and Population Studies, University of Padua.
authors.forename: T
authors.initials: T
authors.lastname: Baldovin
authors.affiliation: A. Buja is PhD, P. Furlan is SD, T. Baldovin is BS and PhD, C. Bertoncello is MD and PhD and V. Baldo is Full Professor, Department of Molecular Medicine, Section of Public Health, Laboratory of Public Health and Population Studies, University of Padua.
authors.forename: C
authors.initials: C
authors.lastname: Bertoncello
authors.affiliation: A. Buja is PhD, P. Furlan is SD, T. Baldovin is BS and PhD, C. Bertoncello is MD and PhD and V. Baldo is Full Professor, Department of Molecular Medicine, Section of Public Health, Laboratory of Public Health and Population Studies, University of Padua.
authors.forename: V
authors.initials: V
authors.lastname: Baldo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003695:Delivery of Health Care / Q000458:organization & administration; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D016330:Frail Elderly; D006301:Health Services Needs and Demand; D006801:Humans; D007558:Italy; D008297:Male; D017146:Models, Organizational; D017063:Outcome Assessment, Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014218:Triage / Q000706:statistics & numerical data*
keywords: Delivery of Health Care; Emergency Service; Geriatrics; Health Care Organizations