Emergency medicine and older adults: continuing challenges and opportunities

Schumacher, John G.

doi:10.1016/j.ajem.2004.12.011

Cited by 66 publications

(49 citation statements)

References 22 publications

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“…The proportion of the aging population is rapidly increasing, and elderly individuals will be the major focus of emergency medicine in the future (Schumacher 2005;Wilber et al 2006).…”

Section: Discussionmentioning

confidence: 99%

Inappropriate Use of Ambulance Services by Elderly Patients with Less Urgent Medical Needs

Horibata¹,

Takemura

2015

Tohoku J. Exp. Med.

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Elderly patients with less urgent medical needs represent a high proportion of all emergency patients in Japan; this trend is gradually increasing, presenting a burden on the emergency medical system. To design effective interventions, it is important to understand the basic characteristics of emergency service use. For elderly Japanese patients, there is currently no detailed report on less urgent cases (LUC), or those cases that could be diagnosed by primary care physicians. Since there is a need for a timely reporting of detailed LUC data, we used data of 2004-2006 from an immediately available database at the Yao Tokushukai General Hospital. With a focus on LUC, we analyzed 7,800 cases of elderly patients, aged over 65 years, who were transported via ambulance to a secondary emergency hospital in Osaka. Of these, 3,354 patients (43.0%) were classified as having initial emergencies and were given outpatient care in the emergency department, and 1,544 patients (19.8%) were LUC, in which 541 subjects (6.9%) may have used ambulance services somewhat inappropriately owing to a lack of alternate transportation. In the remaining 1,003 patients, ambulance use could have been avoided if primary care clinics were available at night and during holidays. We therefore focus on three important points: awareness-raising activities to prevent inappropriate ambulance use, strengthening of transport services to healthcare facilities, and expanding primary care clinic office hours. This study is the first detailed report on the use of ambulance services in Japan by elderly patients with less urgent medical needs.

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“…The proportion of the aging population is rapidly increasing, and elderly individuals will be the major focus of emergency medicine in the future (Schumacher 2005;Wilber et al 2006).…”

Section: Discussionmentioning

confidence: 99%

Inappropriate Use of Ambulance Services by Elderly Patients with Less Urgent Medical Needs

Horibata¹,

Takemura

2015

Tohoku J. Exp. Med.

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“…37 When possible, previously validated survey instruments are preferable, 38 but for our objectives, no such instrument exists. Therefore, our survey instrument was developed by a detailed review of existing research focused on ED interventions to improve geriatric adult emergency care, 5,6,13,15,20,25,26,32,34,35,[39][40][41][42][43][44][45][46] as well as discussions with a multidisciplinary collaboration of representatives from SAEM, ACEP, the American Geriatrics Society, and the Emergency Nurses Association. This collaboration continues to develop geriatric ED infrastructure, personnel, protocol, and educational guidelines.…”

Section: Survey Content and Administrationmentioning

confidence: 99%

“…1,[8][9][10] Strategies for improved ED elder care range from the education and attitude change of emergency providers to the redesign of ED physical plants and departmental operational changes. [11][12][13][14][15][16] One recent and evolving response to the aging demographic imperative is the development of geriatric EDs. The geriatric ED theoretically provides selected improvements in patient care through specialized services and environmental enhancements.…”

mentioning

confidence: 99%

A Profile of Acute Care in an Aging America: Snowball Sample Identification and Characterization of United States Geriatric Emergency Departments in 2013

Hogan

Olade

Carpenter

2014

Academic Emergency Medicine

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Background: The aging of America poses a challenge to emergency departments (EDs). Studies show that elderly patients have poor outcomes despite increased testing, prolonged periods of observation, and higher admission rates. In response, emergency medicine (EM) leaders have implemented strategies for improved ED elder care, enhancing expertise, equipment, policies, and protocols. One example is the development of geriatric EDs gaining in popularity nationwide. To the authors' knowledge, this is the first research to systematically identify and qualitatively characterize the existence, locations, and features of geriatric EDs across the United States.

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“…In recent years emergency service admission for non-emergency reasons increased. It is thought that elderly patients contribute to this increment (11). In our study ambulance mediated admission rate was 12.7% and this ratio may change with the size of the city, transport facilities and patients' habits of using the ambulance system.…”

Section: Discussionmentioning

confidence: 85%

Investigation of Factors Affecting Cost of Geriatric Patients Admitted to the Emergency Department

Kapçı¹,

Tomruk²,

Beceren³

et al. 2013

JAEM

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Objective: Increased health cost, which is one of the major problems of countries, makes cost analysis studies become important in specific age groups and clinics. Although the aged population has an enormous role in increasing health costs, there are not much data about follow-up and treatment costs of geriatric patients in the Emergency Departments. We believe that the data obtained from this study would help to improve some arrangements about the geriatric population in ED's including cost and efficiency. Material and Methods: In this study, we have included patients 65 years and above who were admitted to the Emergency Department from 01 January 2011 to 31 March 2011. We gathered data from detailed examination of computer records and the surveys of patients which we obtained at the first admission. We also used computer and billing records to calculate the total cost of patient application and the distribution of this cost into subgroups. Results: Avarage cost of 536 geriatric patients (40.3% early, 48.1% middle and 11.6% late geriatric age group) who were admitted to the Emergency Department was 137.5±98.6 TL. Also there were statistically significant correlations between costs and count of consultations, staying time in the Emergency Department, hospitalisation, and presence of coronary artery disease and congestive heart failure. Conclusion: In this study, we believe the results, which emphasize elderly patient characteristics and cost elements, might reduce costs to society and social security institution and also it can form a basis for large scale studies in the future. (JAEM 2013; 12: 134-8)

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Emergency medicine and older adults: continuing challenges and opportunities

Cited by 66 publications

References 22 publications

Inappropriate Use of Ambulance Services by Elderly Patients with Less Urgent Medical Needs

Inappropriate Use of Ambulance Services by Elderly Patients with Less Urgent Medical Needs

A Profile of Acute Care in an Aging America: Snowball Sample Identification and Characterization of United States Geriatric Emergency Departments in 2013

Investigation of Factors Affecting Cost of Geriatric Patients Admitted to the Emergency Department

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