Singal B M, Hedges J R, Rousseau E W, Sanders A B, Berstein E, McNamara R M, Hogan T M
Wright State University, Dayton, Ohio.
Ann Emerg Med. 1992 Jul;21(7):802-7. doi: 10.1016/s0196-0644(05)81025-x.
To describe emergency department use by the elderly, to define problems associated with emergency care of the elderly, and to compare these results with those for younger adult patients.
Retrospective, controlled chart review.
Six geographically distinct US hospital EDs.
From each site, a stratified sample (approximately 7:3) of elderly (65 years or older) and nonelderly (21 to 64 years old) control patients treated during the same time period was used.
Standardized review of ED records and billing charges. Comparisons of elderly and control patient groups using chi 2 analysis and Mann-Whitney U test (alpha = 0.05).
Four hundred eighteen elderly patients and 175 nonelderly controls were entered into the study. The elderly were more likely to arrive by ambulance (35% versus 11%; P less than .00001). More elderly than controls presented with conditions of either high or intermediate urgency (78% versus 61%; P less than .0003). The elderly more frequently presented with comorbid diseases (94% versus 63%; P less than .00001). Other findings for the elderly included a longer mean stay in the ED (185 versus 155 minutes; P less than .003), higher laboratory (78% versus 53%; P less than .00001) and radiology (77% versus 52%; P less than .00001) test rates, higher mean overall care charges ($471 versus $344; P less than .00001), and an admission rate (47% versus 19%; P less than .00001) twice that of younger adults.
Resource use and charges associated with emergency care are higher for the elderly than for younger patients. Increases in emergency resources and personnel or improvement in efficiency will be needed to maintain emergency care at present levels as the US population continues to grow and age.
描述老年人对急诊科的利用情况，确定与老年人急诊护理相关的问题，并将这些结果与年轻成年患者的结果进行比较。
回顾性对照图表审查。
美国六个地理位置不同的医院急诊科。
从每个地点选取同一时期接受治疗的老年（65岁及以上）和非老年（21至64岁）对照患者的分层样本（约为7:3）。
对急诊记录和计费进行标准化审查。使用卡方分析和曼-惠特尼U检验（α = 0.05）对老年患者组和对照组进行比较。
418名老年患者和175名非老年对照患者纳入研究。老年人更有可能乘坐救护车前来就诊（35% 对11%；P < 0.00001）。与对照组相比，更多的老年人表现出高度或中度紧急情况（78% 对61%；P < 0.0003）。老年人更频繁地患有合并症（94% 对63%；P < 0.00001）。老年人的其他情况包括在急诊科的平均停留时间更长（185分钟对155分钟；P < 0.003），实验室检查率（78% 对53%；P < 0.00001）和放射学检查率（77% 对52%；P < 0.00001）更高，平均总体护理费用更高（471美元对344美元；P < 0.00001），以及住院率（47% 对19%；P < 0.00001）是年轻人的两倍。
与年轻患者相比，老年人急诊护理的资源使用和费用更高。随着美国人口持续增长和老龄化，需要增加急诊资源和人员或提高效率，以维持目前水平的急诊护理。
