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Increasing importance of the elderly in a trauma system
David E Clark1, Michelle K Chu
1Harvard Injury Control Research Center, Boston, MA, USA. clarkd@mmc.org
The American Journal of Emergency Medicine
|March 7, 2002
Summary
Hospitalizations for injuries have shifted from young males to older females. Length of hospital stay has decreased for most, but elderly patients are now more frequently discharged to skilled nursing facilities (SNF).
Area of Science:
- Trauma systems research
- Public health surveillance
- Geriatric injury epidemiology
Background:
- Injury hospitalization trends have evolved significantly over two decades.
- Understanding demographic shifts in trauma care is crucial for resource allocation.
- Previous studies have not fully captured long-term changes in patient populations and outcomes.
Purpose of the Study:
- To analyze age- and sex-specific trends in injury hospitalizations.
- To evaluate changes in length of stay (LOS) and patient disposition.
- To assess shifts in the utilization of trauma centers across different age groups.
Main Methods:
- Analysis of statewide hospitalization data from 1980-1999.
- Annual evaluation stratified by sex and age groups (0-39, 40-64, 65-99).
- Assessment of incidence, mean LOS, and discharge disposition.
Main Results:
- Hospital admissions shifted from young males (39.6% in 1980 to 20.7% in 1999) to older females.
- Mean LOS decreased for those under 65 and after 1990 for those 65 and older.
- Elderly patients are now more commonly discharged to skilled nursing facilities (SNF) instead of home.
- Trauma center utilization increased for younger patients but remained stable for the elderly.
Conclusions:
- Significant demographic changes necessitate a re-evaluation of trauma system populations.
- Injury prevention strategies targeting the elderly are increasingly vital.
- Cost-effectiveness analyses for geriatric trauma must incorporate SNF outcomes.