GERIATRIC USE OF EMERGENCY MEDICAL-SERVICES

Study objective: To quantify use by geriatric patients of emergency me dical services (EMS) compared with that by young adult patients. Metho ds: We conducted a retrospective, consecutive case series over a 6-mon th period in a suburban, all-paramedic municipal EMS system serving 76 ,500 residents, of whom approximately 15% are 65 years of age or older and 33% are between 25 and 45 years old. Patient age, the sole entry criterion, was used to distinguish two groups: the young adult group, defined as patients 25 to 45 years old; and the geriatric group, defin ed as patients 65 years or older. Results: Of the 2,712 patients whose cases were reviewed during the study period, 1,734 (64%) met the entr y criterion. The geriatric group (n=1,043) accounted for 39% of the to tal call volume, compared with the young adult group (n=690), which ac counted for 25% of total call volume. Patients in the young adult grou p were 7.3 times more likely to have been in a motor vehicle accident, whereas the GP group was 2.6 times more likely to have cardiorespirat ory complaints, 1.8 times more likely to have fallen, and 1.7 times mo re likely to have minor medical problems requiring transportation and more frequently required advanced life support (ALS) care (54% versus 33%) (P<.001 for all comparisons). Scene times for geriatric patients were found to be longer than those for young adults (ALS, P<.001; basi c life support [BLS], P<.05). However, costs billed to the patient wer e greater for young adults for all care rendered (BLS, P<.001; ALS, P< .05). Conclusion: Use by geriatric patients of EMS differed significan tly from that by young adults. Geriatric patients used EMS more freque ntly and required more ALS care than did young adults. Although geriat ric patients required longer scene times for EMS care, young adults in curred greater charges for service. These findings, although perhaps s ystem specific, speak to the need for ongoing analysis of EMS health c are delivery to better serve a population increasing in age.