Study objective: To determine the nature and frequency of ED use by vi
ctims of physical elder abuse. Methods: Community-dwelling victims of
abuse were identified through a state elderly protective service progr
am independent of the health care system in a geographic area served b
y two EDs. ED records were reviewed and abstracted to determine if and
how victims used emergency services. Results: During a 7-year period,
182 elderly victims of physical abuse were identified in the catchmen
t area of the study, and 114 (62.6%) had been seen in one or both EDs
at least once during a 5-year ''window'' surrounding the initial ident
ification of abuse. These 114 individuals accounted for 628 visits (me
dian 3, range 1-46); 30.6% of visits resulted in a hospital admission.
An ordinal system was used that assigned a probability of any single
ED visit being referable to abuse; 37.8% of subjects had at least one
visit categorized as being of high probability, and 66% of subjects ha
d at least one visit that resulted in an injury-related chief symptom
or ICD-9 discharge diagnosis. Conclusion: Elder abuse victims have sub
stantial interactions with EDs and these visits frequently result in a
dmission. Strategies that identify elder abuse in less acute settings
and effectively address the needs of victims would improve quality of
life and likely result in substantial savings in health care expenditu
res.