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Comparative Study
. 2013 Sep 8:13:344.
doi: 10.1186/1472-6963-13-344.

Emergency department use by oldest-old patients from 2005 to 2010 in a Swiss university hospital

Sarah Vilpert  1 , Hélène Jaccard Ruedin, Lionel Trueb, Stéfanie Monod-Zorzi, Bertrand Yersin, Christophe Büla
Affiliations
Comparative Study

Emergency department use by oldest-old patients from 2005 to 2010 in a Swiss university hospital

Sarah Vilpert et al. BMC Health Serv Res. .

Abstract

Background: Aging of the population in all western countries will challenge Emergency Departments (ED) as old patients visit these health services more frequently and present with special needs. The aim of this study is to describe the trend in ED visits by patients aged 85 years and over between 2005 and 2010, and to compare their service use to that of patients aged 65-84 years during this period and to investigate the evolution of these comparisons over time.

Methods: Data considered were all ED visits to the University of Lausanne Medical Center (CHUV), a tertiary Swiss teaching hospital, between 2005 and 2010 by patients aged 65 years and over (65+ years). ED visit characteristics were described according to age group and year. Incidence rates of ED visits and length of ED stay were calculated.

Results: Between 2005 and 2010, ED visits by patients aged 65 years and over increased by 26% overall, and by 46% among those aged 85 years and over (85+ years). Estimated ED visit incidence rate for persons aged 85+ years old was twice as high as for persons aged 65-84 years. Compared to patients aged 65-84 years, those aged 85+ years were more likely to be hospitalized and have a longer ED stay. This latter difference increased over time between 2005 and 2010.

Conclusions: Oldest-old patients are increasingly using ED services. These services need to adapt their care delivery processes to meet the needs of a rising number of these complex, multimorbid and vulnerable patients.

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Figures

Figure 1
Figure 1
Evolution from 2005 to 2010 of emergency department visits by patients aged 65–84 years vs. 85 years and over.
Figure 2
Figure 2
Evolution from 2005 to 2010 of the incidence ratea of Emergency Department visits by the permanent resident population of Lausanneb by age groups. Legend: a And its upper and lower 95% confidence intervals. b Includes districts of Lausanne and West Lausanne, Statistique Vaud 2012.
Figure 3
Figure 3
Probability of Emergency Department dischargea during the first 48 hours of patients aged 65–84 years vs. 85 years and over, 2005 and 2010. Legend: a Home, nursing home or hospital admission. Log-rank comparing patients aged 65–84 years with patients 85 years and older in 2005: P value < 0.001. Log-rank comparing patients aged 65–84 years with patients 85 years and older in 2010: P value < 0.001. Log-rank comparing 2005 to 2010 among patients aged 65–84 years: P value = 0.003. Log-rank comparing 2005 to 2010 among patients aged 85 years and over: P value = 0.010.
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References

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