Abstract
BackgroundFew studies have investigated ambulance utilization in people aged 85 years or older, ie, the oldest old.MethodsWe conducted a 1-year population-based observational study of patients transported by ambulance to emergency departments in Tokyo, Japan, which has a population of about 12 million. Demographic data, symptoms/events associated with ambulance transport, and the proportion of hospital admissions were recorded. Transport rates by age and sex were calculated using data for the background population and ambulance transports, and the 10 most frequent symptoms/events requiring transport were compared between the oldest old and those aged 65 to 84 years.ResultsOf the 642 764 patients who were transported to hospitals by ambulances, 59 570 (9%) were aged ≥85 years; 64% were women. The annual ambulance transport rate for this population was 250 per 1000/year and was significantly greater than the rate (90 per 1000/year) for those aged 65 to 84 years. The highest rate was for men aged 85 to 99 years (292 per 1000/year). Among the oldest old, the most frequent reason for ambulance transport was fall (38.5 per 1000/year), and the symptom most likely to result in hospital admission was dyspnea.ConclusionsThe ambulance transport rate for the oldest old was high, particularly among men aged ≥95 years. To reduce the need for ambulance transport among the oldest old, preventive care is needed to reduce falls and acute exacerbations of cardiac and respiratory disorders.
Highlights
Demographic forces have shaped the age composition of many industrialized countries
Because the oldest old are more likely to have multiple chronic diseases/disabilities, are at higher risk for many acute symptomatic episodes, and require greater health care resources than those aged 65 to years or to 84 years, it is important to investigate the utilization of health care systems among the oldest old
Our study showed a considerably higher ambulance transport rate (250 per 1000/year) among the oldest old, a rate that was almost 3 times that for residents aged 65 to 84 (90 per 1000/ year)
Summary
Demographic forces have shaped the age composition of many industrialized countries. With an increasing proportion of older adults, Japan is a rapidly aging society.[1]. Few studies have investigated ambulance utilization in people aged 85 years or older, ie, the oldest old. Demographic data, symptoms/ events associated with ambulance transport, and the proportion of hospital admissions were recorded. Transport rates by age and sex were calculated using data for the background population and ambulance transports, and the 10 most frequent symptoms/events requiring transport were compared between the oldest old and those aged 65 to 84 years. Results: Of the 642 764 patients who were transported to hospitals by ambulances, 59 570 (9%) were aged ≥85 years; 64% were women. The most frequent reason for ambulance transport was fall (38.5 per 1000/year), and the symptom most likely to result in hospital admission was dyspnea. Conclusions: The ambulance transport rate for the oldest old was high, among men aged ≥95 years. To reduce the need for ambulance transport among the oldest old, preventive care is needed to reduce falls and acute exacerbations of cardiac and respiratory disorders
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