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Influenza and emergency department utilization by elders
Michael J Schull1, Muhammad M Mamdani, Jiming Fang
1Sunnybrook and Women's College Health Sciences Center, 2075 Bayview Avenue, Toronto, Ontario, Canada. mjs@ices.on.ca
Summary
Influenza outbreaks significantly increase emergency department (ED) visits, particularly among elders with respiratory illnesses. Public health efforts should target this demographic to mitigate ED crowding during flu season.
Area of Science:
- Public Health
- Epidemiology
- Emergency Medicine
Background:
- Influenza outbreaks are linked to increased emergency department (ED) crowding.
- The specific mechanisms driving this association require further investigation.
Purpose of the Study:
- To examine the relationship between influenza activity and ED utilization.
- To identify patient demographics and conditions most affected by influenza-related ED visits.
Main Methods:
- Retrospective time series analysis of ED visits and community influenza data in Toronto (1996-1999).
- Longitudinal analysis of ED utilization by age groups (younger vs. older) for major influenza-related (MIR) and upper respiratory infection (URI) diagnoses.
- Psychiatric visits were used as a control group to assess specificity.
Main Results:
- Each ten new community influenza cases correlated with a 1.5% increase in ED visits by elders with MIR conditions and a 1.2% increase for elders with URIs.
- No significant association was found between influenza and ED utilization by younger patients.
- Other respiratory viruses did not show a significant association with ED utilization across any patient group.
Conclusions:
- Influenza seasons disproportionately increase ED utilization among individuals aged 65 and older, primarily for significant respiratory conditions.
- Interventions aimed at reducing the impact of influenza on EDs should prioritize the elderly population.
- Influenza does not appear to significantly affect ED use by younger individuals.