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Cited by 66Emergency and Acute Care StudiesHealthcare Policy and ManagementChronic Disease Management Strategies

Emergency Department Utilization by Noninstitutionalized Elders

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Shah, Manish N., Rathouz, Paul J., Chin, Marshall H.·2001·Academic Emergency Medicine
DOI 10.1111/j.1553-2712.2001.tb01303.x
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Abstract

Abstract. Objectives: To the best of the authors knowledge, no nationally representative, population‐based study has characterized the proportion of elders using the emergency department (ED) and factors associated with ED use by elders. This article describes the proportion of elder Medicare beneficiaries using the ED and identifies attributes associated with elder ED users as compared with nonusers. Methods: The 1993 Medicare Current Beneficiary Survey was used, a national, population‐based, cross‐sectional survey of Medicare beneficiaries linked with Medicare claims data. The study population was limited to 9,784 noninstitutionalized individuals aged 66 years or older. The Andersen model of health service utilization was used, which explains variation in ED use through a combination of predisposing (demographic and social), enabling (access to care), and need (comorbidity and health status) characteristics. Results: Eighteen percent of the sample used the ED at least once during 1993. Univariate analysis showed ED users were older; were less educated and lived alone; had lower income and higher Charlson Comorbidity Index scores; and were less satisfied with their ability to access care than nonusers (p < 0.01, chi‐square). Logistic regression identified older age, less education, living alone, higher comorbidity scores, worse reported health, and increased difficulties with activities of daily living as factors associated with ED use (p < 0.05). Need characteristics predicted ED use with the greatest accuracy. Conclusions: The proportion of elder ED users is slightly higher than previously reported among Medicare beneficiaries. Need (comorbidity and health status) characteristics predict ED utilization with the greatest accuracy.

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Research works printed but not linked: 2

  1. Strange GR, Chen EH, Sanders AB. Use of emergency de- partments by elderly patients: projects from a multicenter da- tabase. Ann Emerg Med. 1992; 21:819-24.
  2. ⅷ 15532712, 2001, 3, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/j.1553-2712.2001.tb01303.x, Wiley Online Library on [30/12/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License

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Authors
Shah, M. N., Rathouz, P. J., & Chin, M. H.
Affiliations
University of Chicago (US)
Corresponding author
Shah, Manish N.
ORCID
Venue
Academic Emergency Medicine
Publisher
Wiley
Published
2001-03
Volume
8
Issue
3
Pages
267-273
ISSN
  • 1069-6563 (ISSN-L)
  • 1553-2712
DOI
10.1111/j.1553-2712.2001.tb01303.x
OpenAlex
W2032891060
Cited by
66
References
35
Citations by year
2026: 1 · 2025: 1 · 2023: 1 · 2022: 4 · 2021: 1 · 2020: 5 · 2019: 3 · 2018: 4 · 2017: 2 · 2016: 3 · 2015: 6 · 2014: 4 · 2013: 2 · 2012: 4
FWCI
3.64
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 2676 d)
Locations
  • Academic Emergency Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
  • Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
Keywords
emergency department utilization, older adults, Medicare beneficiaries, Andersen Behavioral Model, comorbidities, health status, activities of daily living, health care access, socioeconomic factors, living alone, educational attainment, income, health care utilization
MeSH terms
Age Factors, Aged, Aged, 80 and over, Analysis of Variance, Emergency Medical Services, Female, Health Status, Humans, Male, Comorbidity

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