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Using geographic information systems to map older people’s emergency department attendance for future health planning
  1. Eoin O'Mahony1,
  2. Éidín Ní Shé2,
  3. Jade Bailey3,
  4. Hasheem Mannan2,
  5. Eilish McAuliffe2,
  6. John Ryan4,5,
  7. John Cronin5,
  8. Marie Therese Cooney5
  1. 1 The School of Geography, University College Dublin, Dublin, Ireland
  2. 2 School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
  3. 3 School of Medicine, Health Sciences Centre, University College Dublin, University College Dublin, Dublin, Ireland
  4. 4 University College Dublin School of Medicine and Medical Science, Dublin, Ireland
  5. 5 Department of Emergency Medicine, St Vincent's University Hospital, Dublin, Ireland
  1. Correspondence to Dr Eoin O'Mahony, Geography, University College Dublin, Dublin 4, Ireland; eoin.omahony{at}ucd.ie

Abstract

Objectives This study aimed to assess the pattern of use of EDs, factors contributing to the visits, geographical distribution and outcomes in people aged 65 years or older to a large hospital in Dublin.

Methods A retrospective analysis of 2 years of data from an urban university teaching hospital ED in the southern part of Dublin was reviewed for the period 2014–2015 (n=103 022) to capture the records of attenders. All ED presentations by individuals 65 years and older were extracted for analysis. Address-matched records were analysed using QGIS, a geographic information systems (GIS) analysis and visualisation tool to determine straight-line distances travelled to the ED by age.

Results Of the 49 538 non-duplicate presentations in the main database, 49.9% of the total are women and 49.1% are men. A subset comprised of 40 801 had address-matched records. When mapped, the data showed a distinct clustering of addresses around the hospital site but this clustering shows different patterns based on age cohort. Average distances travelled to ED are shorter for people 65 and older compared with younger patients. Average distances travelled for those aged 65–74 was 21 km (n=4177 presentations); for the age group 75–84, 18 km (n=2518 presentations) and 13 km for those aged 85 and older (n=2104 presentations). This is validated by statistical tests on the clustered data. Self-referral rates of about 60% were recorded for each age group, although this varied slightly, not significantly, with age.

Conclusions Health planning at a regional level should account for the significant number of older patients attending EDs. The use of GIS for health planning in particular can assist hospitals to improve their understanding of the origin of the cohort of older ED patients.

  • acute care
  • aged
  • emergency department management
  • emergency department

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Correction notice Since this article was first published online, affiliation 1 has been updated to read the School of Geography.

  • Contributors All the authors have made significant intellectual or practical contributions towards the development of the geographic information systems review. EO’M and ÉNS drafted the manuscript and all authors read, edited and approved the final manuscript.

  • Funding Supported by grant from the Health Research Board for the Systematic Approach for Improving care for Frail Older People (SAFE) study under the Applied Partnership Award Grant No. (APA-2016–1857).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval to conduct the study was provided by St. Vincent’s Healthcare Ethics and Research Committee on 15 February 2017 (Ref SAFE: 23/2/17).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available.

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