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ER Usage in Hamilton

ER Usage in Hamilton. Mar 24, 2003. The Elderly Are High Users of ER’s. Represent 14.5% of Hamilton population 22% of the 150,709 visits to 4 ER sites by all ages (HDHC) 55% male, mean age 71. …But They Don’t Usually Misuse ER’s. 2 year follow- up study, geriatric consults in Montreal ER

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ER Usage in Hamilton

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  1. ER Usage in Hamilton Mar 24, 2003

  2. The Elderly Are High Users of ER’s Represent 14.5% of Hamilton population • 22% of the 150,709 visits to 4 ER sites by all ages (HDHC) • 55% male, mean age 71

  3. …But They Don’t Usually Misuse ER’s • 2 year follow- up study, geriatric consults in Montreal ER 33.9% died, 51.3% admitted to long-term care facility (Sineoff et al, 1998) • Elderly in ER present more often with a life-threatening/ medically urgent condition (Eagle et al, 1993) • 46% of require comprehensive evaluations vs 13% of non-elderly (Strange et al, 1992)

  4. Background • Hamilton has 4 emergency rooms (ER’s) • + 1 urgent care (UC) • Serves population of 491,000 • There are 151,000 annual visits to ER’s • 52,000 to UC

  5. Urgent Care • Treats less seriously ill patients • CTAS scores 3 - 5 • 4308 visits(8.3%) aged 65 or over •  6% of the elderly were transferred for admission to inpatient care

  6. Methods • RGPc has data on all persons over the age of 65 using any of the 4 Hamilton ER’s in fiscal year 2001 – 2002 • Only the data for one hospital (SJHH) allow identification of repeat visitors • Data: arrival/ discharge date + time, age, sex, LOS, site, diagnosis (ICD-9), disposition Supplemented by information in Hamilton District Health Council. Hamilton Health System Fact Book 2002. (www.hdhc.ca)

  7. Utilization by Elderly 14.5% of Hamilton population; 22% of ED visits ALOS per ED visit by elderly: 5.3 hours (triage-D/C)

  8. About 45% Are at Lower Triage Levels

  9. Almost 2/3 Discharged…

  10. Return Visitors • 39% of seniors in Hamilton report visiting family physician 5 or more times (1996/1997, Ont Hlth Surv) • (SJHH FY 2001-2 data only) • 1 return visit in year: 58.0% • 5 or more: 13.8%, • 13 people visited 10 - 38 times = 269 or 2.9% of all visits

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