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Emergency medical services use by the elderly: analysis of a statewide database.

机译：老年人使用紧急医疗服务：对全州数据库的分析。

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BACKGROUND: Elderly patients use emergency medical services (EMS) at a high rate. Objectives. To test the hypothesis that EMS use for emergency department (ED) transports increases across the life span and to estimate changes in the EMS volume in North Carolina (NC) during the next 20 years due to the aging of the population. METHODS: We conducted a retrospective observational study of EMS transports to EDs in the state of NC in 2007. Data were obtained from the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT), which records data for all visits to 105 of the 112 EDs in the state. The association between EMS use and age was assessed using the chi-square test for trend. State demographic projections (U.S. Census Bureau) were used to estimate the increase in EMS use over the next 20 years due to population aging. RESULTS: There were 3,853,866 NC ED visits recorded in 2007. Complete arrival and disposition data were available for 2,743,221 visits (71.2%). Patient visits with and without complete data were similar in mean age (37.4 vs. 37.8 years), percentage female (55.4% vs. 56.1%), and use of EMS (16.9% vs. 16.8%). Visits with complete data were used in the analyses. The proportion of ED visits in which the patient was brought by EMS increased steadily across the life span (p < 0.001). Visits by individuals 65 years of age or older accounted for 14.7% of all visits and 38.3% of all EMS transports to the ED. For those patients aged 85 years and older, EMS was the most common mode of ED arrival (60.6%). We estimate that by 2030, total EMS transports to NC EDs will increase by 47%. Patients 65 years of age and older are projected to account for 70% of this increase and to compose 49% of all EMS transports by 2030. CONCLUSIONS: The proportion of patients using EMS to reach NC EDs increases steadily with age. By 2030, older patients will account for approximately half of EMS transports to NC EDs. The changes likely exemplify national trends and highlight the growth of EMS service needs for the elderly and the importance of emphasizing geriatric care in EMS training.
机译：背景：老年患者大量使用紧急医疗服务（EMS）。目标。为了检验急诊室（ED）运送EMS的使用率在整个寿命期内增加的假设，并估算由于人口老龄化而在未来20年内北卡罗来纳州（NC）的EMS数量的变化。方法：我们在2007年对北卡罗来纳州EMS到ED的运输进行了回顾性观察研究。数据来自北卡罗来纳州疾病事件跟踪和流行病学收集工具（NC DETECT），该工具记录了105例糖尿病患者的所有就诊数据。该州有112名ED。使用卡方检验评估趋势，使用EMS与年龄之间的关联。州人口统计预测（美国人口普查局）用于估算由于人口老龄化而导致的未来20年内EMS使用量的增长。结果：2007年记录了3,853,866次NC ED访问。完整的到达和处置数据可用于2,743,221次访问（71.2％）。有和没有完整数据的患者访视在平均年龄（37.4岁对37.8岁），女性百分比（55.4％对56.1％）和使用EMS（16.9％对16.8％）方面相似。在分析中使用具有完整数据的访问。在整个生命周期中，由EMS带给患者的ED访视比例稳步增加（p <0.001）。 65岁或65岁以上的个人来访占所有访问的14.7％，占所有EMS向ED运送的38.3％。对于那些85岁及以上的患者，EMS是ED到达的最常见方式（60.6％）。我们估计，到2030年，运往NC ED的EMS总运输量将增加47％。到2030年，预计65岁及以上的患者将占这一增长的70％，并构成所有EMS运输的49％。结论：随着年龄的增长，使用EMS达到NC ED的患者比例将稳步增长。到2030年，老年患者将占向NC ED运送EMS的大约一半。这些变化可能是国家趋势的例证，并突出了针对老年人的EMS服务需求的增长以及在EMS培训中强调老年护理的重要性。

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