ER visits increasing for elderly patients: study

NEW YORK (Reuters Health) - The number of emergency department visits by elderly individuals is increasing and is probably going to continue to increase as the population ages, according to a report published in the latest issue of the Annals of Emergency Medicine.

“In 2005, the Centers for Disease Control and Prevention reported increasing emergency department (ED) visit rates per 100 people,” Dr. Mary Pat McKay and colleagues from the George Washington University, Washington, DC, write.

“The greatest increase in visit rate was among individuals 65 years and older,” they note, adding that because older patients have longer ED stays, are more likely to be admitted, and represent a growing segment of the population, “this finding could have a significant negative effect on ED crowding.”

Using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS), the researchers analyzed ED visits by subjects older than 65 years during the years 1993 to 2003. They used annual census data to compute visit rates per 100 persons.

The rate of ED visits for subjects 65 to 74 years increased by 34 percent during the study period. Among black subjects, the visit rate increased by 90 percent to 77 visits per 100 persons per year. The rate for white subjects increased by 26 percent to 36 visits per 100 persons per year.

The researchers classified the ED patients’ primary diagnostic codes into four categories: injury, acute non-injury, exacerbation of chronic condition, and “other” (including such ill-defined problems as weakness, dizziness, etc.).

According to their report, 93 percent of the increase in ED visits was for diagnoses that fell into the “other/undefined” category. There was an increase of 44 percent in the number of visits at which three or more medications were administered.

No significant change was observed in the admission rate during the study period.

“If trends continue, the effects on ED and hospital crowding could be catastrophic, and planning should begin now,” McKay and colleagues conclude.

SOURCE: Annals of Emergency Medicine, June 2008.