Abstract

Abstract --The purpose of this study is to construct a demographic of emergency department (ED) patients and determine the need of special attention on ED geriatric patients. We prospectively studied 16,925 patients who visited ED of a community teaching hospital (Upgraded to medical center in 2001) in Taipei City from April 9, 1999 to June 27, 1999.. The patients were stratified into pediatric (age <15 yr), non-elderly adult (age 15-64 yr), elderly (age 65-74 yr) and extremely old adult (age >75 yr) patients (the later 2 groups were defined as geriatric patients). Their statistical data in gender, ambulance utilization, disease severity, revisiting to ED, resources consumed, medical expenditures, and disease distribution were studied. The geriatric patients occupied 13.9% of the ED visits. According to triage criteria in this study, more than one third (38.4%) of the geriatric patients’ visits were rated as “Triage I “or “II “(higher disease acuity) as compared to16.0% in the pediatric and 24.0% in the non-elderly adult groups. Extremely old patients were more frequently arrived by ambulance then the elderly, non-elderly adult and pediatric patients (9.1% vs 5.5% vs 3.9% vs 0.6%, P<0.001). The geriatric patients occupied 41.7% of the general beds and 45.0% of the ICU beds that used by ED admission. The rate of revisiting within 48-hr period was similar among the four groups whereas that within one-month period was highest in the extremely old aged (13.9% vs 10.9% vs 6.5% vs 6.0%, P<0.001). The geriatric patients especially the extremely old consumed more ED resources and works, stayed a longer time in the ED (mean time of 14.8 hours vs 10.1 hours vs 5.3 hours vs 2.4 hours, P<0.0001), and also incurred a higher mean expenditure per individual (NTD 4765 vs NTD 4487 vs NTD 1930 vs NTD 627, P<0.0001). The leading illness of the geriatric patients was related to gastrointestinal disease as compared to trauma in the non-elderly adult and respiratory disease in the pediatric patients respectively. Our study provided the information that highlighted the escalating demand of geriatric medical service and had the implications on future medical facilities setup, teaching program, clinical research and financial planning.