Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, Australia.
Ambulance Victoria, 375 Manningham Road, Doncaster, Melbourne, Victoria, Australia.
Age Ageing. 2018 Jul 1;47(4):615-619. doi: 10.1093/ageing/afy056.
to examine demand for emergency ambulances by older people.
retrospective cohort study using secondary analysis of routinely collected clinical and administrative data from Ambulance Victoria, and population data from the Australian Bureau of Statistics and the Australian Institute of Health and Welfare.
Victoria, Australia.
people aged 65 years and over, living in Residential Aged Care Facilities (RACF) and the community, attended by emergency ambulance paramedics, 2009-13.
rates of emergency ambulance attendance.
older people living in RACF experienced high rates of emergency ambulance attendance, up to four times those for age- and sex-matched people living in the community. Rates remained constant during the study period equating to a consistent, 1.45% average annual increase in absolute demand. Rates peak among the 80-84-year group where the number of attendances equates to greater than one for every RACF-dwelling person each year. Increased demand was associated with winter months, increasing age and being male.
these data provide strong evidence of high rates of emergency ambulance use by people aged 65 years and over living in RACF. These results demonstrate a clear relationship between increased rate of ambulance use among this vulnerable group of older Australians and residence, sex, age and season. Overall, absolute demand continues to increase each year adding to strain on health resources. Additional research is needed to elucidate individual characteristics, illness and health system contributors to ambulance use to inform strategies to appropriately reduce demand.
调查老年人对急救车的需求。
使用维多利亚救护车的常规收集的临床和行政数据以及澳大利亚统计局和澳大利亚健康与福利研究所的人口数据进行二次分析的回顾性队列研究。
澳大利亚维多利亚州。
2009 年至 2013 年间，年龄在 65 岁及以上、居住在养老院（RACF）和社区、由急救车护理人员照顾的老年人。
急救车就诊率。
居住在养老院的老年人急救车就诊率很高，是年龄和性别匹配的社区居民的四倍。在研究期间，该比率保持不变，相当于绝对需求每年持续增加 1.45%。该比率在 80-84 岁年龄组中达到峰值，每年的就诊次数相当于每个居住在养老院的人每年一次以上。需求增加与冬季月份、年龄增长和男性有关。
这些数据为居住在养老院的 65 岁及以上老年人对急救车的高使用率提供了有力证据。这些结果表明，澳大利亚这一年龄较大的弱势群体中，急救车使用率的增加与居住地点、性别、年龄和季节之间存在明显关系。总体而言，绝对需求每年都在持续增加，给卫生资源带来了压力。需要进一步研究以阐明个体特征、疾病和卫生系统对救护车使用的影响，以便制定适当减少需求的策略。
