EMERGENCY HOSPITAL ADMISSION IN MEDICAL W ARDS - CAUSES, JUSTIFICATION, SOCIAL-FACTORS AND DIFFERENCES WITH RESPECT TO AGE

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.