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Emergency department utilization by noninstitutionalized elders.

M N Shah1, P J Rathouz, M H Chin

  • 1Section of Emergency Medicine, the University of Chicago, Chicago, IL, USA. mashah@medicine.bsd.uchicago.edu

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
|March 7, 2001
PubMed
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Eighteen percent of older Medicare beneficiaries used the emergency department (ED) in 1993. Factors like older age, lower education, living alone, and greater health needs were associated with higher ED use.

Area of Science:

  • Gerontology
  • Health Services Research
  • Public Health

Background:

  • Emergency department (ED) utilization among elders is a significant concern.
  • Previous studies lacked national, population-based data on elder ED use and associated factors.
  • Understanding elder ED use is crucial for healthcare planning and resource allocation.

Purpose of the Study:

  • To determine the proportion of elder Medicare beneficiaries using the ED.
  • To identify demographic, socioeconomic, and health-related factors associated with ED use in this population.

Main Methods:

  • Utilized the 1993 Medicare Current Beneficiary Survey linked with Medicare claims data.
  • Analyzed data from 9,784 noninstitutionalized individuals aged 66 years and older.
  • Applied the Andersen model of health service utilization to examine predisposing, enabling, and need characteristics.

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Main Results:

  • 18% of elder Medicare beneficiaries used the ED at least once in 1993.
  • ED users were older, less educated, lived alone, had lower incomes, and reported poorer access to care.
  • Logistic regression revealed older age, lower education, living alone, higher comorbidity, worse self-reported health, and functional limitations predicted ED use.

Conclusions:

  • The proportion of elder ED users is higher than previously estimated.
  • Health status and comorbidity are the strongest predictors of emergency department utilization among older adults.