The use of emergency ambulance service by elderly patients and assessment of predictors of ambulance use

The proportion of people aged 65 and above is increasing both in Turkey and in the world. Older people are admitted to emergency departments more often and for more severe health problems than young people. Several studies have revealed that the rate of emergency admissions for people aged 65 and above ranges between 9% and 18%. The 112 ambulance utilization rate for patients aged 65 and above ranges between 6% and 40%. Depending on the changes in the population structure, elderly population's admissions to emergency departments and utilization of the 112 ambulance are estimated to increase day by day. This study was designed to determine the utilization of ambulances by patients aged 65 and above who are admitted to emergency departments, as well as to find out the factors affecting their ambulance use, and to assess the profile of these patients. The population of this cross-sectional research comprised patients aged 65 and above, who were admitted to the emergency department of Izmir Dokuz Eylül University Hospital between August 01, 2015 and August 31, 2015. No sample selection was performed; the entire population was intended to reach. To collect the study data, two measuring tools were prepared. While one of the measurement tools was aimed at finding factors affecting patients' ambulance use, the other measurement tool was designed to assess their emergency department use. Throughout the research, 755 patients were admitted to the emergency department. Among those patients, 555 (73.6%) were contacted and included in this study. Of those patients contacted, 53.0% were male and the mean age of the participants was 76.8±7.6 years. We found out that 34.2% of the participants were brought to the emergency department by ambulance. Those living with their families used the ambulance service less often (p <0.05). Significant number of the patients who called the ambulance service by dialing the telephone number 112 within the past year, also tended to reach to the emergency department by calling ambulance service (p <0.05). Most of the patients who were brought to the emergency departments by ambulances were old patients (p <0.05). The reasons why some patients do not call an ambulance to reach to the emergency departments were evaluated. Some patients (59.2%) claimed that it would be faster to go to the emergency department on their own, while others (31.1%) said that their medical condition was not serious enough to call an ambulance. On the other hand, those patients using ambulance service reported that their medical problems needed urgent intervention and using ambulance system was the quickest way to reach to emergency department (67.4%). While 71.9% of the patients were discharged from the emergency department without hospitalization, those who were hospitalized were mostly referred to the departments of internal diseases (72.4%). Consultations were requested from various units for 59.8% of the patients admitted to the emergency department. Most of the patients for whom consultation was requested, had been brought to emergency service by ambulance (p <0.05). The most common diagnosis for the patients admitted the emergency department was gastrointestinal disorders (21.6%). This study which is designed to assess the utilization of emergency departments and ambulance services by elderly patients, as well as to assess the factors affecting their ambulance use is expected to shed light for medical professionals to organize emergency medical services better.