Ji. Gonzalezmontalvo et al., EMERGENCY HOSPITAL ADMISSION IN MEDICAL W ARDS - CAUSES, JUSTIFICATION, SOCIAL-FACTORS AND DIFFERENCES WITH RESPECT TO AGE, Medicina Clinica, 103(12), 1994, pp. 441-444
BACKGROUND: Increasing attention has been given to the care to elderly
patients in emergency departments (ED). Moreover, few data are availa
ble about final phase of the process, that is hospital admission from
ED. This study was conducted to stablish appropriateness, reasons and
social factors related to hospital admission in medical services from
ED and their age-related differences. METHODS: The Appropriateness Eva
luation Protocol scale (AEP) was applied prospectively to 515 patients
15 years and older admitted to medical services through an ED. Patien
ts who did not meet any AEP criteria were evaluated for other medical
or social factors as conditions for their admission. RESULTS: The samp
le was composed by 303 elders (65 years and older, mean age = 77 +/- 6
years) and 212 adults (15-64 years old, mean age = 45 +/- 14). 271 el
derly patients (89.4%) and 173 adults (81.6%) meet AEP criteria (p = 0
.01). Hospitalary admission for diagnostic procedures is more frequent
in younger than in older group (14.2% versus 6.9%, p = 0.01). No diff
erences are detected in hospital admissions based upon strictily socia
l factors: 7 (2.3%) in elderly group and 7 (3.3%) in younger one (p =
0.5). CONCLUSIONS: Urgent hospital admissions in medical services are
justified more frequently in elderly patients. These patients are admi
tted for diagnostic procedures less frequently than younger group. No
age-dependent difference in strictly social admissions is detected.