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Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
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Referral patterns in elderly emergency department visits.

Alessandra Buja1, Marco Fusco, Patrizia Furlan

  • 1Dipartimento di Medicina Molecolare, Università degli Studi di Padova, Padua, Italy.

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|December 17, 2013
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Summary

Elderly patients seeking emergency care present differently based on referral source. Self-referred individuals often have less urgent needs and lower healthcare costs.

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Area of Science:

  • Gerontology
  • Public Health
  • Health Services Research

Background:

  • Elderly individuals represent a significant demographic utilizing emergency department (ED) services.
  • Understanding referral patterns is crucial for optimizing healthcare resource allocation and patient outcomes.

Purpose of the Study:

  • To analyze the characteristics, processes, outcomes, and costs associated with emergency department visits among elderly patients based on their referral pattern.

Main Methods:

  • Retrospective cohort study utilizing data from 18,648 emergency department visits of individuals aged 65 and older in North-Eastern Italy.
  • Analysis of referral patterns including primary care professionals (PCPs), nursing homes (NH), and self-referral (SR).

Main Results:

  • Self-referred (SR) patients constituted 55.5% of visits and were more likely to present with non-urgent conditions but less likely for ambulatory care-amenable conditions.
  • The SR group exhibited shorter ED stays, lower observation unit and hospitalization rates, and reduced overall service consumption compared to PCPs or NH referrals.
  • Average costs per procedure were significantly lower for SR patients (€106.04) compared to those referred by PCPs (€138.14) or NH (€143.48).

Conclusions:

  • Referral patterns significantly influence the characteristics, outcomes, and resource utilization of elderly patients in the emergency department.
  • Self-referral among the elderly is associated with less resource-intensive care, suggesting potential for improved primary care integration and management of non-urgent conditions.