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J Korean Soc Emerg Med > Volume 28(1); 2017 > Article
Journal of The Korean Society of Emergency Medicine 2017;28(1): 87-96.
응급의료센터에 질환으로 내원한 노인요양시설 환자와 일반 노인 환자의 역학적 특징 분석
함은미1, 김한범1, 표창해1, 박상현1, 박근홍1, 곽명관1, 신승열1, 오수빈2, 최한조3
1서울의료원 응급의학과
2속초의료원 응급의학과
3삼성서울병원 응급의학과
Analysis of Epidemiologic Characteristics between Patients Visited from Residential Aged Care Facilities and Elderly Patients Visited from Home Admitted to the Emergency Department with Disease
Eun Mi Ham1, Hahn Bom Kim1, Chang Hae Pyo1, Sang Hyun Park1, Keun Hong Park1, Myoung Kwan Kwak1, Seung Yul Shin1, Su Bin Oh2, Han Jo Choi3
1Department of Emergency Medicine, Seoul Medical Center, Seoul, Korea
2Sokcho Medical Center, Gangwon-do, Korea
3Departement of Emergency Medicine, Samsung Medical Center, Seoul, Korea
Correspondence  Hahn Bom Kim ,Tel: 02-2276-7424, Fax: 02-2276-7418, Email: hahnbom@hanmail.net,
Received: October 20, 2016; Revised: October 20, 2016   Accepted: January 2, 2017.  Published online: February 28, 2017.
In recent years, the number of elderly patients visiting from residential aged care facilities (RACFs) has been increasing. We analyzed a comparison of characteristics between patients who visited the ER with diseases from RACFs and those who visited from home.
A retrospective study was conducted in a public hospital between January 2013 and December 2014. The subjects included patients who visited the ED from RACFs and elderly patients who visited the ED from home. Comparisons of the following parameters were made between the two groups: gender, age, mode of insurance, mode of ED visit, mobile status, Charlson comorbidity index (CCI), chief complaint, final results in the ED, and length of stay (LOS) in the ED and hospital.
A total of 7,603 patients were enrolled during the study period. There were 6,401 elderly patients who visited from home and 1,202 patients who visited from RACFs. Patients from RACFs were older than those from home (79.90± 8.01 vs. 75.78±7.26, p<0.001). More patients from RACFs were on Medicaid (56.6% vs. 27.9%, p<0.001), took more ambulance (86.3% vs. 49.4%, p<0.001), more bedridden (68.2% vs. 6.4%, p<0.001), and higher CCI (2.38±1.99 vs. 1.45±1.84, p<0.001). Compared with patients from home, those from RACFs showed a significantly higher proportion of admission (63.2% vs. 32.9%, p<0.001), ED LOS (403.03±361.77 vs. 277.07±258.82, p<0.001), and hospital LOS (19.65±18.58 vs. 15.67±15.63, p<0.001). Patients from RACFs showed especially longer ED LOS from discharged ED than those from home (388.87±422.88 vs. 221.90±215.30, p<0.001).
Compared with elderly patients from home, patients from RACFs also had higher admission rate and longer ED LOS, as well as hospital LOS. Patients from RACFs had long ED LOS. The findings in this study suggest that there could be ED overcrowding in the near future.
Key words: Emergency service, Hospital, Aged, Residential facilities, Nursing homes
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