Downing Amy, Wilson Richard
Public Health and Epidemiology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
Age Ageing. 2005 Jan;34(1):24-30. doi: 10.1093/ageing/afh214. Epub 2004 Oct 20.
It has previously been reported that patients aged over 65 years account for 15% of Accident and Emergency (A&E) attendances. Despite this, there have been few studies looking at older people's use of A&E. This study describes the A&E attendance patterns of older people, defined as those aged 65 years and over, using data from an NHS region over a number of years. Their attendances are also compared with those of the rest of the population.
A&E attendance data were collected for 14 Acute Trusts in the West Midlands for the period from 1 April 1999 to 31 March 2002 via the West Midlands Accident and Emergency Surveillance Centre.
Patients aged 65 years and over accounted for 18% of all attendances. Attendance rates were highest in those aged over 80 years. Older patients were significantly more likely to attend during the morning and early afternoon, during the winter months, arrive by ambulance and require admission to hospital. Older patients were significantly more likely to attend with non-injury, particularly cardiac-related conditions. Injuries accounted for 33.1% of attendances in the over-65s compared with 59.9% in the 0-64s.
This study is the first in England to look at the A&E attendance patterns of all older people in an NHS region. It has demonstrated the continued high level use of A&E by those aged over 65 years. This highlights the need for continued systemic monitoring of A&E attendance patterns to enable planners to accommodate the impact of the increasingly ageing population.
此前有报道称,65岁以上的患者占急诊就诊人数的15%。尽管如此,针对老年人使用急诊服务的研究却很少。本研究利用国民健康服务体系(NHS)某地区多年的数据,描述了65岁及以上老年人的急诊就诊模式。还将他们的就诊情况与其他人群进行了比较。
通过西米德兰兹急诊监测中心,收集了西米德兰兹地区14家急性信托机构在1999年4月1日至2002年3月31日期间的急诊就诊数据。
65岁及以上的患者占所有就诊人数的18%。80岁以上人群的就诊率最高。老年患者在上午和下午早些时候、冬季就诊的可能性显著更高,更有可能乘坐救护车前来且需要住院治疗。老年患者因非损伤情况就诊的可能性显著更高,尤其是与心脏相关的疾病。65岁以上人群中,损伤导致的就诊占33.1%,而0 - 64岁人群中这一比例为59.9%。
本研究是英国首个针对国民健康服务体系一个地区所有老年人急诊就诊模式的研究。它表明65岁以上人群对急诊服务的使用持续处于较高水平。这凸显了持续对急诊就诊模式进行系统性监测的必要性,以便规划者能够应对人口老龄化加剧带来的影响。