2.50
Hdl Handle:
http://hdl.handle.net/10755/243457
Category:
Abstract
Type:
Presentation
Title:
Older Adults and Patterns of Emergency Department Use: A U.S. Perspective
Author(s):
Mentes, Janet C.; Woods, Diana Lynn; Yefimova, Maria; Cadogan, Mary; Phillips, Linda
Author Details:
Mentes, Janet C., PhD, RN, jmentes@sonnet.ucla.edu; Woods, Diana Lynn , PhD, RN; Yefimova, Maria, BS; Cadogan, Mary, DrPH, RN, GNP; Phillips, Linda, PhD;
Abstract:
 Purpose: Understanding the circumstances that bring older adults to the emergency department (ED) is the first step in tailoring services to meet their needs. Although information about medical diagnosis is recorded, little is known about the influence of geriatric syndromes on their decisions to seek care.  To compare three patterns of ED use based on 2 years of data from a large U.S. urban medical center.  Patterns include clustered repeaters, those with more than 8 visits and at least 3 visits within a 2 month period; non-clustered repeaters, those with more than 3 visits in 2 years with no clustered visits; and single users, those with only one visit.

Methods: There were 18468 ED visits involving individuals 65+.  Factor analysis was used to identify clusters of ED diagnoses which factored into medical diagnoses and symptoms.  Discriminant analysis was used to evaluate whether diagnoses and/or symptoms predicted group membership. 

Results: Demographically, significant differences between the groups included: more diagnosed conditions, longer length of hospital stay, and more African American or individuals with Hispanic ethnicity in the clustered repeater group compared to the other two groups.  Groups were similar with regard to medical diagnoses.  Discriminant analysis showed that older adults with syncope/dizziness, vomiting or an accident/fall were more likely to be in the single user group; whereas persons with generalized symptoms such as abdominal pain, shortness of breath, malaise were more likely to be in the clustered repeater group. 

Conclusion: Different symptoms predicted group membership, suggesting that geriatric syndromes may explain some of the differences in patterns of use. Symptom management is a major nursing role and attention to the fit of the elder’s needs with the ED model of care may be important in reducing particular visit clusters, reducing costs and improving the outcomes of care for older ED users.

 

Keywords:
Emergency Care; Geriatric syndromes
Repository Posting Date:
12-Sep-2012
Date of Publication:
12-Sep-2012
Conference Date:
2012
Conference Name:
23rd International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Brisbane, Australia

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleOlder Adults and Patterns of Emergency Department Use: A U.S. Perspectiveen_GB
dc.contributor.authorMentes, Janet C.en_GB
dc.contributor.authorWoods, Diana Lynnen_GB
dc.contributor.authorYefimova, Mariaen_GB
dc.contributor.authorCadogan, Maryen_GB
dc.contributor.authorPhillips, Lindaen_GB
dc.author.detailsMentes, Janet C., PhD, RN, jmentes@sonnet.ucla.edu; Woods, Diana Lynn , PhD, RN; Yefimova, Maria, BS; Cadogan, Mary, DrPH, RN, GNP; Phillips, Linda, PhD;en_GB
dc.identifier.urihttp://hdl.handle.net/10755/243457-
dc.description.abstract&nbsp;<strong><b>Purpose: </b> </strong>Understanding the circumstances that bring older adults to the emergency department (ED) is the first step in tailoring services to meet their needs. Although information about medical diagnosis is recorded, little is known about the influence of geriatric syndromes on their decisions to seek care.&nbsp;&nbsp;To compare three patterns of ED use based on 2 years of data from a large U.S. urban medical center.&nbsp; Patterns include clustered repeaters, those with more than 8 visits and at least 3 visits within a 2 month period; non-clustered repeaters, those with more than 3 visits in 2 years with no clustered visits; and single users, those with only one visit. <p><b><b>Methods: </b> </b>There were 18468 ED visits involving individuals 65+.<b>&nbsp; </b>Factor analysis was used to identify clusters of ED diagnoses which factored into medical diagnoses and symptoms.&nbsp; Discriminant analysis was used to evaluate whether diagnoses and/or symptoms predicted group membership.&nbsp; <p><b><b>Results: </b> </b>Demographically, significant differences between the groups included: more diagnosed conditions, longer length of hospital stay, and more African American or individuals with Hispanic ethnicity in the clustered repeater group compared to the other two groups. &nbsp;Groups were similar with regard to medical diagnoses.&nbsp; Discriminant analysis showed that older adults with syncope/dizziness, vomiting or an accident/fall were more likely to be in the single user group; whereas persons with generalized symptoms such as abdominal pain, shortness of breath, malaise were more likely to be in the clustered repeater group.&nbsp; <p><b><b>Conclusion: </b></b> Different symptoms predicted group membership, suggesting that geriatric syndromes may explain some of the differences in patterns of use. Symptom management is a major nursing role and attention to the fit of the elder&rsquo;s needs with the ED model of care may be important in reducing particular visit clusters, reducing costs and improving the outcomes of care for older ED users. <p>&nbsp;en_GB
dc.subjectEmergency Careen_GB
dc.subjectGeriatric syndromesen_GB
dc.date.available2012-09-12T09:22:31Z-
dc.date.issued2012-09-12-
dc.date.accessioned2012-09-12T09:22:31Z-
dc.conference.date2012en_GB
dc.conference.name23rd International Nursing Research Congressen_GB
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen_GB
dc.conference.locationBrisbane, Australiaen_GB
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