Prevalence of and predictors for frequent utilization of emergency department of older adults

Abstract

[[abstract]]目的：探討老人使用急診醫療的情形及影響老人頻繁使用急診醫療的相關因素。方法：本研究使用全民健康保險研究資料庫，利用SAS 9.4統計套裝軟體進行資料處理及統計分析，首先使用描述性統計探討老人使用急診醫療的情形；其次，分別以卡方檢定、複邏輯斯迴歸探討影響老人頻繁使用急診醫療的相關因素。結果：研究對象共計128,228人，其中有31,957人曾經使用急診醫療，使用率為24.92%，總急診人次為62,605人次，有使用急診醫療老人平均每人使用次數為1.96次。影響老人頻繁使用急診醫療的顯著因素為男性、大於等於75歲、低收入戶、投保地位於一般鄉鎮市區及高齡化市鎮地區、前一年門診就診大於30次、前一年曾經住院、CCI分類大於等於3分者。結論：有多種因素會影響老人是否會成為頻繁使用急診醫療者。因此，建議醫療管理者及衛生政策制定者，推動及落實老人急診病人周全性老年評估，以提升老人急 診病人的整體照護品質。 Objectives: To explore the prevalence of and predictors for frequent utilization of emergency department by older adults. Methods: The 2010 Longitudinal Health Insurance Database (LHID2010) released by the National Health Research Institute of Taiwan was processed and analyzed using SAS version 9.4. Descriptive statistics was used to explore the emergency care utilization data of older adults in Taiwan. A χ2 test and multivariate logistic regression were used to explore the correlations factors frequent utilization of emergency department by older adults . Results: Of the 128,228 research subjects, 31,957 (24.92%) had accessed emergency care a total of 62,605 person-times, an average of 1.96 times for each person. The factors contributing to frequent utilization of emergency care included sex, age group, economic status (i.e., low income or not), degree of urbanization at insurance location, and the medical utilization and health status of patients in the previous year. Conclusions: Numerous factors affect whether older adults frequently use emergency medical care. Therefore, medical administrators and health care policymakers should promote and implement a comprehensive assessment of elderly emergency patient to improve the overall quality of the care of such patients