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Emergency department use by the rural elderly.
D M Lishner1, R A Rosenblatt, L M Baldwin
1Department of Family Medicine, University of Washington, Seattle, WA 98195-4696, USA.
The Journal of Emergency Medicine
|March 24, 2000
Summary
Elderly individuals in remote rural areas visit emergency departments (EDs) less often than urban counterparts. However, the reasons for ED visits and the conditions treated are similar, requiring rural EDs to handle comparable emergency cases.
Area of Science:
- Geriatric Medicine
- Health Services Research
- Rural Health
Background:
- Emergency department (ED) utilization patterns differ between urban and rural populations.
- Understanding these differences is crucial for equitable healthcare access for elderly Medicare beneficiaries.
Purpose of the Study:
- To compare emergency department (ED) use among elderly Medicare beneficiaries residing in urban, adjacent rural, and remote rural areas.
- To analyze the types of conditions, severity, and physician specialties involved in ED visits across different geographic locations.
Main Methods:
- Utilized Medicare data from Washington State in 1994, specifically the National Claims File.
- Classified beneficiaries by residence (urban, adjacent rural, remote rural).
- Identified ED visits, diagnostic codes, condition severity, and physician specialties.
Main Results:
- Elderly individuals in remote rural areas were 13% less likely to use ED services compared to urban residents.
- The primary causes for ED visits among the elderly showed no significant variation based on geographic location.
- The majority of ED visits were for conditions deemed appropriate for an emergency setting.
Conclusions:
- Despite lower utilization rates, the elderly in remote rural areas face similar emergency medical needs as their urban counterparts.
- Rural emergency departments require the capacity to manage the same spectrum of conditions as urban EDs to ensure consistent care quality.