Motives behind low-acuity geriatric emergency medicine attenders: a picture from free healthcare system

Ir J Med Sci. 2023 Dec;192(6):3091-3099. doi: 10.1007/s11845-023-03359-w. Epub 2023 Apr 17.

Abstract

Background: Current evidence about the low-acuity ED visits of old patients has been generated in various healthcare systems; however, this is not a well-researched area in middle-income countries by patients' perspectives.

Methods: A study of 231 patients attending the ED of a tertiary public hospital was conducted using a structured questionnaire from June to August 2021. Eligible patients were community-dwelling, aged > 65 years, who presented with lower clinical urgency. The questionnaire tool was developed using questions from available studies on health service utilization. Additional commentary was obtained from the patients regarding on the reasons for attending the ED and was administered on weekdays between 8:00 am and 5:30 pm.

Results: The study included 221 patients over 65 years of age, with a mean age of 72.21 ± 4.2. A total of 58.4% of the patients thought that they should be examined urgently, 15.4% had symptoms that had lasted more than one month, and 59% requested emergency imaging. Patients preferred the ED via treatment, imaging, transportation opportunities of emergency department, past negative experiences, and access problems with family medicines or appointment problems with specialist outpatient clinics with expectations of continuity of care.

Conclusion: Old individuals have unique healthcare needs, and the motives behind this group of patients with low-acuity problems to apply to the ED is complex. As one of the key objectives of healthcare policies is to make sure that patients are assessed at proper time and place, studies that consider patient perspectives might lead to accurate conclusions for this aim.

Keywords: Emergency medicine; Geriatric health; Health system organisation; Overcrowding.

MeSH terms

  • Aged
  • Ambulatory Care Facilities
  • Delivery of Health Care
  • Emergency Medicine*
  • Emergency Service, Hospital
  • Humans
  • Motivation*
  • Surveys and Questionnaires