Association Between Age Older Than 75 Years and Exceeded Target Waiting Times in the Emergency Department: A Multicenter Cross-Sectional Survey in the Paris Metropolitan Area, France - 24/10/13
, Christophe Vincent-Cassy, MD b, Benjamin Bloom, MD c, Bruno Riou, MD, PhD a, e, Patrick Ray, MD, PhD d, eAPHP Emergency Database Study Group
Address for correspondence: Yonathan Freund, MDSupervising editor: Rita K. Cydulka, MD, MS
Résumé |
Study objective |
We seek to evaluate whether age greater than 75 years is an independent predictor of prolonged waiting time in the emergency department (ED).
Methods |
We retrospectively analyzed all adult attendances to 9 EDs within the Paris area during 2011. The primary endpoint was target waiting time exceeded, defined as a waiting time for medical assessment longer than the maximal recommended waiting time according to triage level. To assess our primary objective, we performed logistic regression using patient- and ED-related variables to determine whether age greater than 75 years was independently associated with higher rate of target waiting time exceeded.
Results |
A total of 317,793 patients were included, of whom 173,629 (55%) had an exceeded target waiting time. Mean age was 45.8 years and 12.7% were older than 75 years. Target waiting time was exceeded for 55% of patients: 53% for patients younger than 75 years (95% confidence interval [CI] 53% to 54%) versus 64% for older patients (95% CI 63% to 65%), relative risk 1.20. In the multivariate analysis, age greater than 75 years was independently associated with an exceeded target waiting time (odds ratio [OR] 1.30; 95% CI 1.27 to 1.33). Other variables associated with exceeded target waiting time were triage level (OR 5.45 [95% CI 5.32 to 5.60] for triage level 2 versus triage level 4), high daily occupancy (OR 3.78 [95% CI 3.53 to 4.03]), day of the week (OR 1.12 [95% CI 1.09 to 1.14] for Monday), and time of the visit (OR 1.79 [95% CI 1.76 to 1.82] from 6 pm to 8 am).
Conclusion |
Patients older than 75 years are less likely to be seen within the target waiting time.
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| Author contributions: All authors participated in article preparation and approved the final version. YF and PR were responsible for drafting the article. YF, CV-C, BR, and PR were responsible for study design and analysis. CV-C was responsible for data management. YF and BB were responsible for conducting the statistical analysis. YF, BB, BR, and PR were responsible for interpreting the results. BB was responsible for extensive reviewing and corrections of the article. BR and PR were responsible for revising the article. YF takes responsibility for the paper as a whole. |
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| Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). The authors have stated that no such relationships exist. Dr. Freund had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. |
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| Publication dates: Available online May 23, 2013. |
Vol 62 - N° 5
P. 449-456 - novembre 2013 Retour au numéro
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