title: The Effect of Older Age on EMS Use for Transportation to an Emergency Department.
abstract: Introduction Previous studies have found that older adults are more likely to use Emergency Medical Services (EMS) than younger adults, but the reasons for this remain understudied. Hypothesis/Problem This study aimed to determine if older age is associated with using EMS for transportation to an emergency department (ED) after controlling for confounding variables.
  
  
  METHODS
  A cross-sectional survey study was conducted at a large academic medical center. Data on previous medical history, chief complaint, self-perceived illness severity, demographic information, and mode of arrival to the ED were collected on all subjects. Those who arrived to the ED via EMS also were asked reasons why they opted to call an ambulance for their illness/injury. Descriptive statistics were used to quantify survey responses, and multivariable regression was used to assess the independent effect of age on mode of ED arrival.
  
  
  RESULTS
  Data from 1,058 subjects were analyzed, 449 (42%) of whom arrived to the ED via EMS. Compared to adults<55 years, the unadjusted prevalence ratio for the association between age and EMS use was 1.18 (95% CI, 0.96-1.45) for subjects 55-79 years and 1.54 (95% CI, 1.18-2.02) for subjects ≥80 years. After adjustment for confounding variables, age remained a statistically significant risk factor for EMS use (P<.05).
  
  
  CONCLUSIONS
  Older age is an independent risk factor for transportation to the ED via ambulance; however, this effect is attenuated by number of chronic medical conditions and history of depression. Additional research is needed to account for confounders unmeasured in this study and to elucidate reasons for the increased frequency of EMS use among older adults. Jones CMC , Wasserman EB , Li T , Amidon A , Abbott M , Shah MN . The effect of older age on EMS use for transportation to an emergency department. Prehosp Disaster Med. 2017;32(3):261-268.
authors.affiliation: 1Department of Emergency Medicine,University of Rochester,School of Medicine and Dentistry,Rochester,New YorkUSA.
authors.forename: Courtney M C
authors.initials: CMC
authors.lastname: Jones
authors.affiliation: 1Department of Emergency Medicine,University of Rochester,School of Medicine and Dentistry,Rochester,New YorkUSA.
authors.forename: Erin B
authors.initials: EB
authors.lastname: Wasserman
authors.affiliation: 1Department of Emergency Medicine,University of Rochester,School of Medicine and Dentistry,Rochester,New YorkUSA.
authors.forename: Timmy
authors.initials: T
authors.lastname: Li
authors.affiliation: 1Department of Emergency Medicine,University of Rochester,School of Medicine and Dentistry,Rochester,New YorkUSA.
authors.forename: Ashley
authors.initials: A
authors.lastname: Amidon
authors.affiliation: 1Department of Emergency Medicine,University of Rochester,School of Medicine and Dentistry,Rochester,New YorkUSA.
authors.forename: Marissa
authors.initials: M
authors.lastname: Abbott
authors.affiliation: 1Department of Emergency Medicine,University of Rochester,School of Medicine and Dentistry,Rochester,New YorkUSA.
authors.forename: Manish N
authors.initials: MN
authors.lastname: Shah
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000552:Ambulances / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006299:Health Services for the Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York; D011795:Surveys and Questionnaires; D014187:Transportation of Patients / Q000706:statistics & numerical data
keywords:  ED emergency department;  EMS Emergency Medical Services;  PCP primary care physician; Emergency Medical Services; emergency medicine; older adults