Older adults use the emergency department appropriately

Excerpt

In the last few years, the emergency department (ED) has faced a continuous increase in visits [1], in part due to its excessive use for nonurgent problems. It is a common opinion that the elderly are partially responsible for this overcrowding, although for a long time it has been known that their ED use is appropriate [1, 2]. Indeed, they have multiple health problems and require more time and resources than younger patients. They are also more frequently admitted than young adults [1, 3]. A recent article further reports that elderly patients use the ED more often for high-intensity than low-intensity visits [4]. Similarly, regarding triage codes, increasing age is associated with a higher prevalence of emergent and urgent (63 vs. 34% in younger) as opposed to semiurgent and nonurgent visits, at least in the United States [5] and in Canada [6]. In other countries, the situation may be different. In Italy, for example, nearly 68% of the ED visits are codified as semiurgent and fewer than 10% are defined as emergent/urgent [1]. Disappointingly, these data are not distinguished by age, and comparison with ED utilization patterns of younger (<65-year-olds) subjects is often not available. Nonetheless, personal data in a sample of 200 Italian elderly (≥65-year-olds) ED patients [7] indicate that 68% of the visits are semiurgent (as many as in the general population), whereas urgent visits are more frequent (nearly 25%). …