Factors predicting emergency room utilization in a 70-year-old population

Emergency room (ER) utilization in a representative sample (n = 605) of 70-year-old Jerusalem residents was investigated using multiple and logistic regression techniques. Around 23% of the study population visited an ER during the pre-interview year. Problems associated with ER use were heart diseases (mainly ischemic), asthma, renal disorders, psychiatric problems, headaches, and nocturia. Also associated with increased ER use were prior hospital admissions, taking sleeping pills, driving a car, distance from one's general practitioner, and low self-assessed health status. The availability of help from children increased ER use, possibly by sharing in the decision-making process or by helping with post-visit financial bureaucracy. Persons with cognitive problems had decreased ER use, possibly due to their inability to cope with the related complex decision-making process. The inclusion of interaction terms improved the models fit, in keeping with the general philosophy of geriatric care which often deals with cases presenting multiple diagnoses in addition to various social problems. Information on key variables identified as predictors of ER use in order to predict ER use as a basis for budget allocation to specific sick funds, was collected by means of a postal questionnaire or by phone.