A profile of older emergency department attendees: findings from an Irish study

Abstract

Aims: This paper is a report of a study of older emergency department attendees' demographic, health and social profiles.

Background: Relative to the general population, older people are higher users of hospital emergency departments. Attendance is most often associated with medical need, including a chronic condition and related morbidities.

Method: A series of standardized health and social profiling questionnaires was administered to a non-probability sample of 307 older emergency department attendees. The sample was recruited during the spring-summer and autumn-winter periods in 2008 and 2009 at two hospitals in the city of Dublin. Subjects who met the inclusion criteria were recruited as they presented to the emergency department during the hours 8 am to midnight. The sample was stratified into those admitted and those discharged, with the aim of equally representing each stratum. Data were collected at the time of the index visit or shortly following hospital admission.

Findings: Medical conditions accounted for almost half of all reasons for attendance and the health profile of the sample was characteristic of a population of chronically ill older people. Relative to the national picture for older people's social networks in Ireland, a proportion of the sample was at risk of social isolation.

Conclusions: In the absence of other avenues to treatment and based on health profile and diagnostic category, older people's attendance at the emergency department was appropriate. The hospital emergency department remains a major arm of the Irish health service in dealing with the morbidity associated with enduring illness.