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Factors associated with hospital admission of elder cardiovascular patients in an emergency center.

机译：与急诊中心老年心血管患者住院的相关因素。

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摘要

Context. Healthcare utilization of elder cardiovascular patients in United States will increase in near future, due to an aging population. This trend could burden urban emergency centers, which have become a source of primary care.; Objective. The objective of this study was to determine the association of age, gender, ethnicity, insurance and other presenting variables on hospital admission in an emergency center for elder cardiovascular patients.; Design, setting and participants. An anonymous retrospective review of emergency center patient login records of an urban emergency center in the years 2004 and 2005 was conducted. Elder patients (age ≥ 65 years) with cardiovascular disease (ICD91 390-459) were included. Multivariate logistic regression analysis was used to identify independent factors for hospital admission. Four major cardiovascular reasons for hospitalisation -- ischemic heart disease, heart failure, hypertensive disorders and stroke were analysed separately.; Results. The number of elder patients in the emergency center is increasing, the most common reason for their visit was hypertension. Majority (59%) of the 12,306 elder patients were female. Forty five percent were uninsured and 1,973 patients had cardiovascular disease. Older age (OR 1.10; CI 1.02-1.19) was associated with a marginal increase in hospital admission in elder stroke patients. Elder females compared to elder males were more likely to be hospitalised for ischemic heart disease (OR 2.71; CI 1.22-6.00) and heart failure (OR 1.58; CI 1.001-2.52). Furthermore, insured elder heart failure patients (OR 0.54; CI 0.31-0.93) and elder African American heart failure patients (OR 0.32; CI 0.13-0.75) were less likely to be hospitalised. Ambulance use was associated with greater hospital admissions in elder cardiovascular patients studied, except for stroke.; Conclusion. Appropriate health care distribution policies are needed for elder patients, particularly elder females, uninsured, and racial/ethnic minorities. These findings could help triage nurse evaluations in emergency centers to identify patients who were more likely to be hospitalised to offer urgent care and schedule appointments in primary care clinics. In addition, health care plans could be formulated to improve elder primary care, decrease overcrowding in emergency centers, and decrease elder healthcare costs in the future.
机译：上下文。由于人口老龄化，美国老年人心血管病患者的医疗保健利用将在不久的将来增加。这种趋势可能使已经成为初级保健来源的城市急救中心负担加重。目的。这项研究的目的是确定年龄，性别，种族，保险和其他呈现变量在老年心血管病急诊中心住院的相关性。设计，设置和参与者。对2004年和2005年城市急诊中心急诊中心患者登录记录进行了匿名回顾性审查。纳入了年龄较大（≥65岁）的心血管疾病患者（ICD91 390-459）。使用多元逻辑回归分析来确定住院的独立因素。分别分析了住院的四大心血管原因-缺血性心脏病，心力衰竭，高血压疾病和中风。结果。急诊中心的老年患者数量在增加，他们来诊的最常见原因是高血压。在12306名老年患者中，绝大多数（59％）是女性。 45％未投保，有1,973名患者患有心血管疾病。老年（OR 1.10； CI 1.02-1.19）与中风老年患者住院率略有增加有关。与老年男性相比，老年女性因缺血性心脏病（OR 2.71； CI 1.22-6.00）和心力衰竭（OR 1.58； CI 1.001-2.52）住院的可能性更高。此外，投保的老年心力衰竭患者（OR 0.54； CI 0.31-0.93）和非裔美国人心衰患者（OR 0.32； CI 0.13-0.75）不太可能住院。除中风外，在研究的老年心血管患者中，使用救护车与住院次数增加有关。结论。对于老年患者，尤其是老年女性，没有保险的人和种族/族裔少数民族，需要采取适当的医疗保健分配政策。这些发现可以帮助在急诊中心对护士进行分流评估，以识别出更有可能住院以提供紧急护理的患者，并安排初级保健诊所的预约时间。此外，可以制定医疗保健计划，以改善老年人的初级保健，减少急诊中心的人满为患，并降低未来的老年人医疗保健费用。

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  • 作者

    Teegala, Shyam Mohan Reddy.;

  • 作者单位

    The University of Texas School of Public Health.$bHealth promotion & Behavioral Sciences Management.;

  • 授予单位 The University of Texas School of Public Health.$bHealth promotion & Behavioral Sciences Management.;
  • 学科 Health Sciences Medicine and Surgery.; Health Sciences Public Health.; Health Sciences Health Care Management.
  • 学位 M.P.H.
  • 年度 2008
  • 页码 59 p.
  • 总页数 59
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 预防医学、卫生学;预防医学、卫生学;
  • 关键词

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