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Publication Date

12-7-2016

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Advisor:

C Schifter Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA.

Abstract

The American population is aging rapidly, with significant ramifications for the health care delivery system. This demographic trend is changing emergency care, with emergency departments caring for more acutely ill older adults and, increasingly, providing a care coordination role. This evolution may be more acute in Pennsylvania’s nonmetropolitan areas, as older adults disproportionately reside outside urban areas. The purposes of this study were to document where older Pennsylvanians receive emergency care and measure emergency “geriatric readiness” relative to recent multidisciplinary guidelines. As such, we assessed the following factors: emergency department annual volume, hospital urban/rural classification, percent of total patient volume comprised of older adults, emergency department practices and resources, community resources, and provider perspective. One hundred and fifty-three Pennsylvania hospital emergency departments were sent a four-part survey and ED Directors for each hospital were asked to describe the geriatric emergency care in their hospital. Forty-five responded to the survey. Our data demonstrates the inverse relationship between annual ED volume and percentage of older adults, such that Pennsylvania’s smaller EDs are also the “oldest”. Responses also show that emergency department resources are not always available, some geriatric-specific protocols are not used, and ED leaders perceive difficulty in coordinating care with community resources. Responses also concluded that there is no significant difference in the availability of resources, use of most screens and protocols, or ease of coordinating with community resources between volume categories. Overall, this study found that Pennsylvania emergency departments are lacking in geriatric-specific resources and protocols. With the impending increase in geriatric patients in the coming years, it is imperative to address this issue.

Presentation: 14:11

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