Outcome of Attendance by an Elderly Population to an Emergency Department as Measured by a Behavioural Model

Abstract

This study addresses the question of factors associated with admission of persons 70 years and over from the Emergency Department of a 374 bed community based general hospital 530 consecutive persons were assessed Factors associated with admission or discharge, were defined within the behavioural model as described by Anderson (1968). Seventy‐three percent of persons were admitted. Outcome, defined as decision to admit or discharge, in this age cohort was not influenced by predisposing or enabling factors as defined by the model Medical need in terms of diagnostic label was the predominant factor in decision making. ADL function, but not cognitive state, was an additional factor in outcome. Equity of access to hospital was demonstrated for this population sample. Elderly patients who present to the Emergency Department were found to do so because they predominantly have acute illness. This cohort of persons is heterogeneous in character and their needs require individual assessment For Emergency Department outcomes to change it is suggested that the pivotal factors relate to the clinical evaluation of perceived and evaluated aspects of client illness and the technological response to them.