https://doi.org/10.4081/ecj.2025.13499
Dynamics of geriatric emergency care: comprehensive assessment of emergency medical services utilization and its impact on healthcare resources in coastal India
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: 2 April 2025
Emergency Medical Services (EMS) transport significantly influences demographics, admission rates, and mortality among geriatric patients presenting to the Emergency Department (ED). The study evaluated geriatric patients aged 65 years and older, focusing on the impact of transport methods—EMS versus walk-ins—on demographics, admission rates, and mortality outcomes, aiming to identify key areas for improving emergency care delivery for this vulnerable population. Of the total patients, 8.5% were transported by EMS who were predominantly male and more likely to arrive during weekends and nighttime hours. Admission rates were significantly higher in the EMS group, with 30.6% requiring ICU care compared to 5.9% of walk-ins. Mortality rates were also markedly elevated among EMS patients (4.7% vs. 0.3%). The reasons for ED visits varied, with trauma being more frequent in EMS arrivals. This study underscores the critical impact of transport methods on patient outcomes, emphasizing the need to optimize EMS protocols and triage practices. Addressing these factors can enhance care delivery and improve admission and mortality outcomes for geriatric patients in ED settings.
Downloads
United Nations. World Population Prospects: The 2017 Revision, World Population Wall chart. Department of Economic and Social Affairs; New York, NY, USA: 2017.
Akpınar O, Türkdoğan KA, Kapçı, et al. Use of emergency department by elderly patients. J Clin Anal Med 2014;6:310-14.
Gulacti U, Lok U, Celik M, et al. The ED use and non-urgent visits of elderly patients. Turk J Emerg Med 2016;16:141-145.
Nawar EW, Niska RW, Xu J. National Hospital Ambulatory Medical Care Survey: 2005 emergency department summary. Adv Data 2007;29:1-32.
Lumjeaksuwan M, Patcharasopit S, Seksanpanit C, et al. The trend of emergency department visits among the elderly in Thailand. WHO South-East Asia J Public Health 2021;10:25-8.
Kaeley N, Kumar J, Kumar M, Vempalli N, Dhar M, Bhardwaj BB, Kumar S, Kabi A, Arora P. Prevalence and pattern of geriatric emergencies in a teaching hospital of North India. J Family Med Prim Care 2021;10:3899-3903.
Dinh MM, Russell SB, Chalkley D, et al. Demand for emergency services trends in New South Wales years 2010–2014 (DESTINY): age and clinical factors associated with ambulance transportation to emergency departments. Prehospital Emergency Care. 2016;20:776–82.
Noergaard CL, Brabrand M, Lassen A. Patients in prehospital transport to the emergency department: a cohort study of risk factors for 7-day mortality. Eur J Emerg Med 2018;25:341–7.
Zachariasse JM, Seiger N, Rood PP, et al. Validity of the Manchester Triage System in emergency care: A prospective observational study. PLoS One 2017;12:e0170811.
Jana A, Sarkar A, Parmar V, Saunik S. Examining district-level disparity and determinants of timeliness of emergency medical services in Maharashtra, India. Sci Rep 2023;13:21239.
Sarfraz Z, Sarfraz A, Sarfraz M, et al. Lessons learnt from emergency medicine services during the COVID-19 pandemic: A case study of India and the United States. Ann Med Surg (Lond) 2022;73:103197.
Castillo EM, Brennan JJ, Howard J, et al. Factors associated with geriatric frequent users of emergency departments. Ann Emerg Med 2019;74:270-275.
Miró Ò, Jacob J, García-Lamberechts EJ, et al. Red de investigación SIESTA, Sociodemographic characteristics, functional status, and health resource use of older patients treated in Spanish emergency departments: a description of the EDEN cohort. Emergencias 2022;34:418-427.
Bellou A, Conroy SP, Graham CA. The European curriculum for geriatric emergency medicine. Eur J Emerg Med 2016;23:239.
Tokuda Y, Abe T, Ishimatsu S, Hinohara S. Ambulance transport of the oldest old in Tokyo: a population-based study. J Epidemiol 2010;20:468-472.
Measures of population ageing, Department of Economic and Social Affairs, Population Division. New York: United Nations; 2020;1:13–15.
Alruwaili A, Alanazy ARM. Prehospital time interval for urban and rural emergency medical services: a systematic literature review. Healthcare 2022;10:2391.
Da Ros F, Di Gaspero L, Roitero K, et al. Supporting fair and efficient emergency medical services in a large heterogeneous region. J Healthc Inform Res 2024;8:400-437.
Brouns SHA, Wachelder JJ, Jonkers FS, et al. Outcome of elderly emergency department patients hospitalised on weekends - a retrospective cohort study. BMC Emerg Med 2018;18:9.
Fayyaz J, Khursheed M, Umer M, et al. Pattern of emergency department visits by elderly patients: study from a tertiary care hospital, Karachi. BMC Geriatr 2013;12:83.
Southerland LT, Lo AX, Biese K, et al. Concepts in practice: geriatric emergency departments. Ann Emerg Med 2020;75:162-170.
Misch F, Messmer AS, Nickel CH, et al. Impact of observation on disposition of elderly patients presenting to emergency departments with non-specific complaints. PLoS One 2014;28:e98097.
Fujisaki I, Yang K, Ueda K. On an effective and efficient method for exploiting the wisdom of the inner crowd. Sci Rep. 2023;13:3608.
Pitkälä KH, Martin FC, Maggi S, et al. Status of geriatrics in 22 countries. J Nutr Health Aging 2018;22:627-631.
Elamin A, Tsoutsanis P, Sinan L, et al. Emergency general surgery: predicting morbidity and mortality in the geriatric population. Surg J NY 2022;19;8:e341.
Rosted E, Poulsen I, Hendriksen C, Petersen J. Testing a two step nursing intervention focused on decreasing rehospitalizations and nursing home admission post discharge from acute care. Geriatr Nurs 2013;34:477-85.
Devriendt E, De Brauwer I, Vandersaenen L, et al. Geriatric support in the emergency department: a national survey in Belgium. BMC Geriatr 2017;17:68.
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
