Factors Influencing Low-Acuity Emergency Department Visits Among the Elderly in Catalonia
Resumen
Objective: This study aims to identify the factors influencing low-acuity visits to emergency departments (EDs) among the elderly, focusing on chronic conditions, income, healthcare access, and demographic characteristics.
Methods: Using longitudinal data from the Catalan public health system (2014–2020), we analysed a cohort of elderly individuals (65+) to examine associations between sociodemographic characteristics, healthcare access, and low-acuity ED visits. Econometric models, including Poisson and Negative Binomial regressions, were employed to control time-related factors (e.g., holidays, weekends) and healthcare supply-side variables (e.g., primary care access).
Results: Chronic conditions were not significantly associated with higher rates of low-acuity ED visits, suggesting that older adults with chronic diseases may not necessarily rely on EDs for care. Higher-income individuals were less likely to use the ED. Nationality (which may proxy cultural and other factors) also influenced ED utilisation, as did hospital complexity—more complex hospitals have higher rates of low-acuity visits, incurring higher costs. Peak periods for low-acuity visits were identified, suggesting that extended primary care hours could reduce ED strain.
Conclusions: The study highlights the role of healthcare access, income, and demographic factors in using low-acuity EDs among the elderly. Strategies to optimise primary care access and redirect non-urgent cases to lower-cost facilities could help reduce ED overuse and improve resource allocation, particularly in times of high demand.
Methods: Using longitudinal data from the Catalan public health system (2014–2020), we analysed a cohort of elderly individuals (65+) to examine associations between sociodemographic characteristics, healthcare access, and low-acuity ED visits. Econometric models, including Poisson and Negative Binomial regressions, were employed to control time-related factors (e.g., holidays, weekends) and healthcare supply-side variables (e.g., primary care access).
Results: Chronic conditions were not significantly associated with higher rates of low-acuity ED visits, suggesting that older adults with chronic diseases may not necessarily rely on EDs for care. Higher-income individuals were less likely to use the ED. Nationality (which may proxy cultural and other factors) also influenced ED utilisation, as did hospital complexity—more complex hospitals have higher rates of low-acuity visits, incurring higher costs. Peak periods for low-acuity visits were identified, suggesting that extended primary care hours could reduce ED strain.
Conclusions: The study highlights the role of healthcare access, income, and demographic factors in using low-acuity EDs among the elderly. Strategies to optimise primary care access and redirect non-urgent cases to lower-cost facilities could help reduce ED overuse and improve resource allocation, particularly in times of high demand.
Palabras Clave
Emergency Service, Low-Acuity, Elderly, Health Services Accessibility, Socioeconomic Factors