title: ED Utilization and Self-Reported Symptoms in Community-Dwelling Older Adults.
abstract: The rise in ED utilization among older adults is a nursing concern, because emergency nurses are uniquely positioned to have a positive impact on the care of older adults. Symptoms have been associated with ED utilization; however, it remains unclear whether symptoms are the primary reason for ED utilization. The purpose of this study was to describe the self-reported symptoms of community-dwelling older adults prior to accessing the emergency department and to examine the differences in self-reported symptoms among those who did and did not utilize the emergency department.
  
  
  METHODS
  A prospective longitudinal design was used. The sample included 403 community-dwelling older adults aged 75 years and older. Baseline in-home interviews were conducted followed by monthly telephone interviews over 15 months.
  
  
  RESULTS
  Commonly reported symptoms at baseline included pain, feeling tired, and having shortness of breath. In univariate analysis, pain, shortness of breath, fair/poor well-being, and feeling tired were significantly correlated with ED utilization. In multivariable models, problems with balance and fair/poor well-being were significantly associated with ED utilization.
  
  
  CONCLUSIONS
  Several symptoms were common among this cohort of older adults. However, no significant differences were found in the types of symptoms reported by older adults who utilized the emergency department compared with those who did not utilize the emergency department. Based on these findings, it appears that symptoms among community-dwelling older adults may not be the primary reason for ED utilization.
authors.affiliation: Spokane, WA; Birmingham, AL. Electronic address: gordana.dermody@wsu.edu.
authors.forename: Gordana
authors.initials: G
authors.lastname: Dermody
authors.affiliation: Spokane, WA; Birmingham, AL.
authors.forename: Patricia
authors.initials: P
authors.lastname: Sawyer
authors.affiliation: Spokane, WA; Birmingham, AL.
authors.forename: Richard
authors.initials: R
authors.lastname: Kennedy
authors.affiliation: Spokane, WA; Birmingham, AL.
authors.forename: Courtney
authors.initials: C
authors.lastname: Williams
authors.affiliation: Spokane, WA; Birmingham, AL.
authors.forename: Cynthia J
authors.initials: CJ
authors.lastname: Brown
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000407:Alabama / Q000453:epidemiology; D004417:Dyspnea / Q000453:epidemiology* / Q000503:physiopathology; D016529:Emergency Nursing / Q000379:methods; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005221:Fatigue / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D010146:Pain / Q000453:epidemiology* / Q000503:physiopathology; D011446:Prospective Studies; D012307:Risk Factors; D057566:Self Report
keywords: Activities of daily living; Aged; Emergency service; Locomotion; Rural populations