Injury and medical expenditure in emergency department visits of older veterans.

Abstract

The purpose of the present study was to investigate the injury types and medical utilization profiles of veterans in emergency department visits by using big data from the National Health Insurance program in Taiwan. We used the outpatient prescriptions and treatment records between 1997 and 2010 of veterans aged ≥65 years in the National Health Insurance Research Database. The International Classification of Diseases, Ninth Revision, Clinical Modification codes 800-999 (i.e. injuries) were selected, and the emergency medical treatment and the medical institutions' basic profile were recorded. A total of 287 113 veterans were selected for this study. The average age was 77.4 years, and most participants were men (71.2%). The total medical expenses were US$46.0 million (an average of US$160.00 per person). Contusions/abrasions, open wounds, and fractures comprised 29.2%, 26.6% and 16.3% of the injuries, respectively. In addition, contusions/abrasions, open wounds, and fractures comprised 23.8%, 21.5% and 19.8%, respectively, of the total medical expenses. The highest charges for a single injury episode were for spinal cord and nerve injuries (an average of US$349.00 per person). Regarding sex differences, women mainly experienced fractures and contusions/abrasions, whereas men experienced open wounds. The injury rate of veterans was reported higher than the non-veterans. Preventive methods are proposed to decrease the occurrences of injury, number of emergency visits and medical expenses. Geriatr Gerontol Int 2016; 16: 1254-1262.