Objectives & Background The average age of patients occupying the ED in Beaumont ED is seen to be rising and this fact coupled with an aging population points to potential future demand pressures on ED departments. This research looks at the changing age profile of patients that attend the ED and the relationship between age and waiting time or Patient Experience Time (PET) in the ED. This research is part of a wider research project looking to simulate patient flows through the ED.
Methods We analysed a 10 year dataset from the ED at Beaumont Hospital to study trends in average patient age and PETs. We then applied linear regression to the 2013 data, (60,000 patient visits to the ED), to examine the relationship between age and PET. Three separate models were developed with PET, time from admission to first medical and time from bed request to being admitted to hospital as the respective dependent variables. These models also controlled for triage type, patient admitted (Yes/No), number in ED and other factors.
Results The average age of ED patients has risen from 43.8 years in 2005 to 48.2 years in 2014 (Figure 1). These older patients have a greater likelihood of admission and in addition experience longer waiting times in ED (See Figures 2 and 3). Using a regression analysis, age was seen to contribute an extra half an hour in PET per 10 year increase. Age had, in contrast, a negative effect on time to first medical with lower waiting times for older age groups. In the final model, predicting the patient time from bed request to being admitted to hospital, age emerged as the most significant factor, with older patients experiencing significantly longer waits. Figure 4 demonstrates these findings, in particular the significant proportion of PET for older patients due to bed requests.
Conclusion Age has a significant effect on patient experience time in the ED. The time to first medical care is mainly driven by triage category, but even controlling for this, older people receive care faster. However, subsequently older patients spend longer in the ED and this is due to longer waits for older patients for a hospital bed. The result is an ED populated with elderly boarders. With an ageing national population in Ireland this research emphasises a need to plan for the future healthcare of elderly patients within and beyond acute hospitals⇓⇓⇓⇓.
- emergency departments
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