- 期刊
Analysis of Emergency Department Utilization by Elderly Patients Under National Health Insurance
全民健康保險老人急診醫療利用分析
摘要
Elderly persons are thought to use emergency departments（EDs）disproportionately. This phenomenon has implications for policy-making as the population of the elderly continues to increase. This study aimed to characterize national ED utilization by elderly patients（?65 years old）, compared with that by younger patients（15-64 years old）. The sample was selected from the National Health Insurance Research Database for the year 2000. There were 519,003 visits to adult EDs in the 12medical centers sampled. The study used a secondary data analysis and included 14 variables. The elderly accounted for 28.5% of all adult ED visits. Compared with younger patients, a greater proportion of elderly patients were male（61.6% υS. 47.7%, P ＜ 0.001）: had chronic diseases'（11.9% υs. 8.0%, P ＜ 0.001）, were major cases（6.7% υs. 4.1 %, p ＜ 0.001）, made no co-payment（38.5% υS. 5.8%, P ＜ 0.001）, were frequent users of outpatient services（28.4% υS. 9.9%, P ＜ 0.001）, were higher-level emergencies（60.0% υS. 43.7%, P ＜ 0.001）, had longer stays in the ED（14.0% υS. 4.7%, P ＜ 0.001）, and had higher costs per visit（NT$4,814 ± 6,046 υS. 2,779± 5,533, P ＜ 0.001）. In addition, elderly patients used 40.8% of total adult ED costs. Older patients have distinct patterns of ED use, and use emergency services at a higher rate than younger patients. ED staff should be knowledgeable about the unique and complex presentations of older ED patients.
並列摘要
Elderly persons are thought to use emergency departments（EDs）disproportionately. This phenomenon has implications for policy-making as the population of the elderly continues to increase. This study aimed to characterize national ED utilization by elderly patients（?65 years old）, compared with that by younger patients（15-64 years old）. The sample was selected from the National Health Insurance Research Database for the year 2000. There were 519,003 visits to adult EDs in the 12medical centers sampled. The study used a secondary data analysis and included 14 variables. The elderly accounted for 28.5% of all adult ED visits. Compared with younger patients, a greater proportion of elderly patients were male（61.6% υS. 47.7%, P ＜ 0.001）: had chronic diseases'（11.9% υs. 8.0%, P ＜ 0.001）, were major cases（6.7% υs. 4.1 %, p ＜ 0.001）, made no co-payment（38.5% υS. 5.8%, P ＜ 0.001）, were frequent users of outpatient services（28.4% υS. 9.9%, P ＜ 0.001）, were higher-level emergencies（60.0% υS. 43.7%, P ＜ 0.001）, had longer stays in the ED（14.0% υS. 4.7%, P ＜ 0.001）, and had higher costs per visit（NT$4,814 ± 6,046 υS. 2,779± 5,533, P ＜ 0.001）. In addition, elderly patients used 40.8% of total adult ED costs. Older patients have distinct patterns of ED use, and use emergency services at a higher rate than younger patients. ED staff should be knowledgeable about the unique and complex presentations of older ED patients.