Emergency department use by the rural elderly

This study uses Medicare data to compare emergency department (ED) use by r ural and urban elderly beneficiaries. The U.S. Health Care Financing Admini stration's National Claims File was used to identify services provided to M edicare beneficiaries in Washington State in 1994. Patients were classified by urban, adjacent rural, or remote rural residence. We identified ED visi ts and associated diagnostic codes, assigned severity levels for presenting conditions, and determined the specialties of physicians providing ED serv ices. The rural elderly living in remote areas are 13% less likely to visit the ED than their urban counterparts. Causes of ED use by the elderly do n ot vary meaningfully by location. Most ED visits by this group are for cond itions that seem appropriate for this setting. Given the similarity of diag nostic conditions associated with ED visits, rural EDs must be capable of d ealing with the same range of emergency conditions as urban EDs. (C) 2000 E lsevier Science Inc.