Acute care of elderly inmates: A vulnerable patient population in emergency department from Turkey

Abstract

Aim: Anatomic and physiological changes make the elderly more susceptible to diseases. Elderly prisoners are more likely to get ill in comparison with their non-prisoner peers because of inadequate access to health care and medicines, and they often have referrals to emergency departments. This study evaluates the elderly inmate emergency department admissions in Turkey. Material and Method: A retrospective cross-sectional descriptive study was conducted in the emergency department of a tertiary healthcare facility with approximately 210,000 admissions annually. Inmate patients ≥65 years of age were included. The 140 total patients were categorized as Group 1 (65-84 years) or Group 2 (>85 years). Emergency referrals were grouped as surgical, medical, psychiatric disorders, and injury. Results: Correlation between categorical variables was analysed with Pearson chi-square test, and the effect of each factor on variables dependent on multiple factors was tested using logistic regression analysis. A total of 140 elderly inmates were eligible for the study. There was the highest number of patients in the medical group (n=98, 70%), and the least in the injury and psychiatric groups (n=4, 2.8%). Cardiovascular system disorders were the leading referral cause. Males had a greater hospitalization rate (p=0.033) and females had no injuries. Recurrence was higher in Group 2 (p=0.007). 92 patients (67.6%) were discharged from emergency department. The mortality rate was 2% (n=17). Discussion: The number of elderly inmates and thus the corresponding rates of acute care in the inmate population are gradually increasing. Already-overburdened EDs are usually the first referral units for all health problems of this vulnerable population in Turkey. Therefore, prisons should provide critical healthcare on-site for their medically vulnerable elderly population.

An Evidence Review of Ageing, Long-Term Care Provision and Funding Mechanisms in Turkey: Using Existing Evidence to Estimate Long-Term Care Cost

“…Several studies showed poverty and low educational attainment to have significant adverse effects on older people's health status and quality of life [30,31,[33][34][35]. These differentials appear more pronounced among highly disadvantaged groups of older people, such as in-prison populations [36].…”