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[Emergency hospital admission in medical services: causes, justification, social factors, and their differences in
J I González-Montalvo1, J J Baztán, L Rodríguez-Mañas
1Servicio de Geriatría, Hospital Central de la Cruz Roja, Madrid.
Background:
Increasing attention has been given to the care to elderly patients in emergency departments (ED). Moreover, few data are available about final phase of the process, that is hospital admission from ED. This study was conducted to establish appropriateness, reasons and social factors related to hospital admission in medical services from ED and their age-related differences.
Methods:
The Appropriateness Evaluation Protocol scale (AEP) was applied prospectively to 515 patients 15 years and older admitted to medical services through an ED. Patients who did not meet any AEP criteria were evaluated for other medical or social factors as conditions for their admission.
Results:
The sample was composed by 303 elders (65 years and older, mean age = 77 +/- 6 years) and 212 adults (15-64 years old, mean age = 45 +/- 14). 271 elderly patients (89.4%) and 173 adults (81.6%) meet AEP criteria (p = 0.01). Hospitalary admission for diagnostic procedures is more frequent in younger than in older group (14.2% versus 6.9%, p = 0.01). No differences are detected in hospital admissions based upon strictly social factors: 7 (2.3%) in elderly group and 7 (3.3%) in younger one (p = 0.05).
Conclusions:
Urgent hospital admissions in medical services are justified more frequently in elderly patients. These patients are admitted for diagnostic procedures less frequently than younger group. No age-dependent difference in strictly social admissions is detected.