Parboosingh E J, Larsen D E
Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Alberta, Canada.
Med Care. 1987 Dec;25(12):1139-47. doi: 10.1097/00005650-198712000-00003.
The authors analyzed predictors of the frequency and appropriateness of utilization of an emergency room by a random sample of 75 noninstitutionalized persons aged 65 years and older in a large city in Canada, using the Andersen and Newman model of medical care utilization as a framework. The total amount of variance explained in the frequency of utilization (47%) exceeded that explained by other studies of utilization of various health services by the elderly. Attitude toward health care, prior experience with the hospital system, and number of sources of health care were important predictors of the frequency of presentation to the emergency room. Almost one half (46.7%) were appropriate users; younger age and prior experience were important predictors of appropriateness of use. The results suggest that the elderly are more appropriate users of the emergency room than younger persons; educational interventions by family physicians could contribute to further improvement.
作者以加拿大一个大城市中75名65岁及以上非机构化老人的随机样本为对象，采用安德森和纽曼医疗服务利用模型作为框架，分析了急诊室使用频率和合理性的预测因素。在使用频率方面所解释的总方差量（47%）超过了其他关于老年人各种医疗服务使用情况的研究。对医疗保健的态度、之前在医院系统的经历以及医疗保健来源数量是前往急诊室就诊频率的重要预测因素。近一半（46.7%）的人是合理使用者；年龄较小和之前的经历是使用合理性的重要预测因素。结果表明，老年人比年轻人更适合使用急诊室；家庭医生开展的教育干预有助于进一步改善情况。
