The aim of this study was to determine which factors are related to Accidents and Emergency Unit (AEU) use by the elderly Spanish population. Observational analysis of the 2014 European Survey of Health in Spain (ESHS-2014; N = 6,520) and the 2017 Spanish Health Survey (SHS-2017; N = 7,024) was employed. About one third (4,095, 30.2%) of the sample used the AEU, and they were primarily women (32.6%). Comorbidity (p = .01), presence of physical limitation in the prior 6 months to the survey, and a history of several diseases (p < .001)—as in diabetes (p < .001), osteoarthritis (p < .001), and chronic bronchitis, emphysema, or chronic obstructive pulmonary disease (p < .001)—were associated with AEU visits in both surveys. Female sex and several cardiovascular diseases were only significant in the ESHS-2014. In the SHS-2017, depressive status was an independent risk factor. This epidemiological data allow a better understanding of the use of AEU, suggesting indications for the care process.
AaltoA.ElovainioM.KivimäkiM.UutelaA.PirkolaS. (2012). The Beck Depression Inventory and General Health Questionnaire as measures of depression in the general population: A validation study using the Composite International Diagnostic Interview as the gold standard. Psychiatry Research, 197, 163-171.
2.
AbarB.HongS.AaserudeE.HolubA.DeRienzoV. (2017). Access to care and depression among emergency department patients. Journal of Emergency Medicine, 53, 30-37.
3.
Andalusian Health Service, Ministry of Health. (2016). Plan for the improvement of emergency services of hospitals of the public health system of Andalusia. Seville, Spain: Junta de Andalucia.
4.
Barroeta UrquizaJ.Boada BravoN. (2011). Los servicios de emergencia y urgencias médicas extrahospitalarias en España [Accidents and Emergency Unit services in Spain]. Madrid. Retrieved from http://www.epes.es/wp-content/uploads/Los_SEM_en_Espana.pdf
5.
BeckA. T.SteerR. A.BrownG. K. (1996). BDI-II: Beck Depression Inventory, second edition. San Antonio, TX: The Psychological Corporation.
6.
ConchaO. P.GallegoB.HillmanK.DelaneyG. P.CoieraE. (2014). Do variations in hospital mortality patterns after weekend admission reflect reduced quality of care or different patient cohorts? A population-based study. BMJ Quality & Safety, 23, 215-222.
7.
de la Revilla AhumadaL.BailónE.de Dios LunaJ.DelgadoA.PradosM. A.FleitasL. (1991). [Validation of a functional social support scale for use in the family doctor’s office]. Atencion Primaria, 8, 688-692.
8.
DeschodtM.DevriendtE.SabbeM.KnockaertD.DebouttleP.BoonenS.MilisenK. (2015). Characteristics of older adults admitted to the emergency department (ED) and their risk factors for ED readmission based on comprehensive geriatric assessment: A prospective cohort study. BMC Geriatrics, 15, Article 54.
9.
Diez-QuevedoC.RangilT.Sanchez-PlanellL.KroenkeK.SplitzerR. I. (2001). Validation and utility of the Patient Health Questionnaire in diagnosing mental disorders in 1003 general hospital Spanish inpatients. Psychosomatic Medicine, 63, 679-686.
10.
Domingo-SalvanyA.BacigalupeA.CarrascoJ. M.EspeltA.FerrandoJ.BorrelC. (2013). [Proposals for social class classification based on the Spanish National Classification of Occupations 2011 using neo-Weberian and neo-Marxist approaches]. Gaceta Sanitaria, 27, 263-272.
11.
EngelB.SchindlerC.LeuppiJ. D.RutishauserJ. (2017). Predictors of re-exacerbation after an index exacerbation of chronic obstructive pulmonary disease in the REDUCE randomised clinical trial. Swiss Medical Weekly, 147, w14439.
12.
FabbianF.De GiorgiA.ManfrediniF.LambertiN.ForcelliniS.StorariA.. . . ManfrediniR. (2016). Impact of renal dysfunction on in-hospital mortality of patients with severe chronic obstructive pulmonary disease: A single-center Italian study. International Urology and Nephrology, 48, 1121-1127.
13.
FranchiC.CartabiaM.SantaluciaP.BavieraM.ManucciP. M.FortinoI.. . . NobiliA. (2017). Emergency department visits in older people: Pattern of use, contributing factor, geographical differences and outcomes. Aging Clinical and Experimental Research, 29, 319-326.
14.
Garcia-AymerichJ.MonsóE.MarradesR. M.EscarrabillJ.FélezM. A.SunyerJ.. . . EFRAM Investigators. (2001). Risk factors for hospitalization for a chronic obstructive pulmonary disease exacerbation: EFRAM Study. American Journal of Respiratory and Critical Care Medicine, 164, 1002-1007.
15.
GreenbergP. E.FournierA. A.SisitskyT.PikeC. T.KesslerR. C. (2015). The economic burden of adults with major depressive disorder in the United States (2005 and 2010). The Journal of Clinical Psychiatry, 76, 155-162.
16.
LangabeerJ. R.IIChampagne-LangabeerT.FowlerR.HenryT. (2019). Gender-based outcome differences for emergency department presentation of non-STEMI acute coronary syndrome. The American Journal of Emergency Medicine, 37, 179-182.
17.
LowthianJ.CurtisA.StoelwinderJ.McNeilJ.CameronP. (2013). Emergency demand and repeat attendances by older patients. Internal Medicine Journal, 43, 554-560.
18.
LozaE.Lopez-GomezJ. M.AbasoloL.MaeseJ.CarmonaL.Batlle-GualdaE. & Artrocad Study Group. (2009). Economic burden of knee and hip osteoarthritis in Spain. Arthritis & Rheumatism, 61, 158-165.
19.
Madrid Health Service, Ministry of Health. (2016). Master plan for emergencies and sanitary emergencies of the community of Madrid 2016-2019. Madrid, Spain: Community of Madrid.
20.
ManfrediniR.De GiorgiA.FabbianF. (2017). Acute diseases, emergency admissions and mortality during weekends: Should be worried?Journal of Thoracic Disease, 9, 2723-2727.
21.
ManfrediniR.FabbianF.CappadonaR.ModestiP. A. (2018). Daylight saving time, circadian rhythms, and cardiovascular health. Internal and Emergency Medicine, 13, 641-646.
Ministry of Health, Social Services and Equality and National Institute of Statistics. (2014). European Health Survey in Spain EESE 2014. Available from http://www.mscbs.gob.es/estadisticas/microdatos.do
NgC. T.TanM. P. (2013). Osteoarthritis and falls in the older person. Age & Ageing, 42, 561-566.
27.
ReyesB. J.LopezJ. M.GalindoD. J.BricenoM.OuslanderJ. G. (2017). Baseline characteristics and outcomes of older adults seeking care in ambulatory urgent care clinics. Journal of the American Geriatric Society, 65, 2702-2706.
28.
RobertsD. C.McKayM. P.ShafferA. (2008). Increasing rates of emergency department visits for elderly patients in the United States, 1993 to 2003. Annals of Emergency Medicine, 51, 769-774.
SalviF.MorichiV.GrilliA.GiorgiR.de TommasoG.Dessì-FulgheriP. (2007). The elderly in the emergency department: A critical review of problems and solutions. Internal and Emergency Medicine, 2, 292-301.
31.
SamarasN.ChevalleyT.SamarasD.GoldG. (2010). Older patients in the emergency department: A review. Annals of Emergency Medicine, 56, 261-269.
32.
Sánchez-López MdelP.DreschV. (2008). The 12-Item General Health Questionnaire (GHQ-12): Reliability, external validity and factor structure in the Spanish population. Psicothema, 20, 839-843.
33.
SchumacherJ. G.DeimlingG. T.MeldonS.WoolardB. (2006). Older adults in the Emergency Department: Predicting physicians’ burden levels. The Journal of Emergency Medicine, 30, 455-460.
34.
SepehrvandN.AlemayehuW.KaulP.PelletierR.BelloA. K.WelshR. C.. . . EzekowitzJ. A. (2018). Ambulance use, distance and outcomes in patients with suspected cardiovascular disease: A registry-based geographic information system study. European Heart Journal: Acute Cardiovascular Care. Advance online publication. doi:10.1177/2048872618769872
35.
SinghJ. A.YuS. (2016a). Emergency department and inpatient healthcare utilization due to hypertension. BMC Health Service Research, 16, Article 303.
36.
SinghJ. A.YuS. (2016b). Utilization due to chronic obstructive pulmonary disease and its predictors: A study using the U.S. National Emergency Department Sample (NEDS). Respiratory Research, 17, Article 1.
37.
SpectorW. D.MutterR.OwensP.LimcangcoR. (2012). Thirty-day, all-cause readmissions for elderly patients who have an injury-related inpatient stay. Medical Care, 50, 863-869.
38.
SteinmillerJ.RoutasaloP.SuominenT. (2015). Older people in the emergency department: A literature review. International Journal of Older People Nursing, 10, 284-305.
39.
TudelaP.MòdolJ. M. (2015). On hospital emergency department crowding. Emergencias, 27, 113-120.
