Shaha Maya, Gmür Selina, Schoenenberger Andreas W, Gerber Fabienne Sarah, Exadaktylos Aristomenis K
Department of Research and Development, Directorate of Nursing and Allied Health Professions, Inselspital, Bern University Hospital, Switzerland; Institute of Higher Education and Research in Nursing, University of Lausanne, Switzerland.
Faculty of Medicine, University of Bern, Switzerland.
Swiss Med Wkly. 2015 May 21;145:w14141. doi: 10.4414/smw.2015.14141. eCollection 2015.
The numbers of people attending emergency departments (EDs) at hospitals are increasing. We aimed to analyse trends in ED attendance at a Swiss university hospital between 2002 and 2012, focussing on age-related differences and hospital admission criteria.
We used hospital administrative data for all patients aged ≥16 years who attended the ED (n=298,306) at this university hospital between 1 January 2002, and 31 December 2012. We descriptively analysed the numbers of ED visits according to the admission year and stratified by age (≥65 vs <65 years).
People attending the ED were on average 46.6 years old (standard deviation 20 years, maximum range 16‒99 years). The annual number of ED attendances grew by n=6,639 (27.6%) from 24,080 in 2002 to 30,719 in 2012. In the subgroup of patients aged ≥65 the relative increase was 42.3%, which is significantly higher (Pearson's χ2=350.046, df=10; p=0.000) than the relative increase of 23.4% among patients<65 years. The subgroup of patients≥65 years attended the ED more often because of diseases (n=56,307; 85%) than accidents (n=9,844; 14.9%). This subgroup (patients≥65 years) was also more often admitted to hospital (Pearson's χ2=23,377.190; df=1; p=0.000) than patients<65 years.
ED attendance of patients≥65 years increased in absolute and relative terms. The study findings suggest that staff of this ED may want to assess the needs of patients≥65 years and, if necessary, adjust the services (e.g., adapted triage scales, adapted geriatric screenings, and adapted hospital admission criteria).
医院急诊科就诊人数在不断增加。我们旨在分析2002年至2012年期间瑞士一家大学医院急诊科就诊的趋势，重点关注年龄相关差异和住院标准。
我们使用了该大学医院2002年1月1日至2012年12月31日期间所有年龄≥16岁且到急诊科就诊患者（n = 298,306）的医院管理数据。我们按就诊年份并根据年龄（≥65岁与<65岁）分层，对急诊科就诊人数进行了描述性分析。
到急诊科就诊的患者平均年龄为46.6岁（标准差20岁，年龄范围16 - 99岁）。急诊科就诊的年人数从2002年的24,080人增加到2012年的30,719人，增加了n = 6,639人（27.6%）。在年龄≥65岁的患者亚组中，相对增加为42.3%，显著高于年龄<65岁患者亚组23.4%的相对增加（Pearson卡方检验χ2 = 350.046，自由度df = 10；p = 0.000）。年龄≥65岁的患者亚组因疾病到急诊科就诊的频率更高（n = 56,307；85%），而非因事故（n = 9,844；14.9%）。该亚组（年龄≥65岁的患者）住院的频率也高于年龄<65岁的患者（Pearson卡方检验χ2 = 23,377.190；自由度df = 1；p = 0.000）。
年龄≥65岁患者的急诊科就诊人数在绝对值和相对值上均有所增加。研究结果表明，该急诊科的工作人员可能需要评估年龄≥65岁患者的需求，并在必要时调整服务（如适用的分诊量表、适用的老年筛查和适用的住院标准）。
