Elderly Visits to Emergency Departments Accelerating
Washington, DC -- Rates of visits by elderly to emergency departments are increasing more rapidly than for any other group, which could lead to catastrophic overcrowding as the ranks of patients over the age of 65 swell, according to a study appearing today in the Annals of Emergency Medicine ("Increasing Rates of Emergency Department Visits for Elderly Patients in the United States, 1993 to 2003").
"Seniors are using the emergency department more and more frequently, and given the needs of this population and the nature of their medical problems, the current state of overcrowding is likely to continue to escalate dramatically," said Mary Pat McKay, MD, of The George Washington University Medical Center in Washington, DC. "These patients tend to be sicker and are more likely to be admitted from the emergency department to the hospital, but with many hospitals running a deficit of inpatient beds, I don't see where these patients are going to go."
Researchers studied emergency department visits from 1993 through 2003, and found that the visit rate per 100 people age 65 and older increased faster than the visit rate for any other age group, with an overall increase of 26 percent over the 11 years of the study. People aged 65 and older are the fastest growing segment of the U.S. population. As emergency patients, they use the most resources, stay the longest, and are the most likely to be admitted to the hospital of all emergency patients. Researchers conclude that emergency department visits in the United States for patients between 65 and 74 could nearly double from 6.4 million in 2003 to 11.7 million by 2013.
"Emergency departments should not be relied upon as substitutes for primary care, but very often they are," said AARP Policy Director John Rother. "The trends released today underscore the need to make sure emergency departments can meet the demand for care by older people, but we also need a better understanding of why emergency room use by older people is on the rise and why these patients may not be getting care from their personal physicians. Our elected leaders should heed the warnings of this new survey and recognize that our health care system needs to deliver quality, affordable care in the most appropriate, cost-effective setting. Americans want their elected officials to work together to provide the health security that everyone needs and deserves."
"Many emergency departments are already overwhelmed with patients waiting hours for medical care," said Dr. McKay. "Just continuing the trend for elderly patients over the next few years could cause the emergency care system to collapse. Patients are already boarding in hallways, sometimes for as long as several days. At this rate, I could see patients waiting in the street because there just isn't any more room."
The study finds that the additional emergency department visits over time were not less urgent than at the beginning of the study, and suggests that older Americans are having more true emergencies, rather than increasingly visiting the emergency department for convenience or because of lack of access to nonemergency outpatient care.
Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, a national medical society with more than 25,000 members. ACEP is committed to advancing emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies. For more information visit www.acep.org.
