Older adults present to emergency medical services with a multitude of clinical and functional needs due to polypharmacy and multipathology. Older adults with mental health needs require additional time for the more comprehensive assessment required as a result of their underlying mental health condition. This article compares the time spent in emergency departments by older adults who have a mental health need with those who do not. Information on how they access prehospital and inhospital care is examined alongside key factors that impact on time spent in emergency departments. Data were collected from hospital records of older adults presenting at emergency departments in 3 large Health and Social Care Trusts in the United Kingdom using a retrospective, secondary, official personal information database source over 1 year. A total sample of 74,766 attendance records of older adults older than 65 years were examined. adults who presented with or had a mental health condition in their diagnosis or history, which made up a subsample of 1,818 people, were found to have significant differences in the time spent in emergency departments and some notable differences in trends and admission patterns. They wait longer than the older person without mental health needs, are more likely to breach the 4-hr waiting time target, are admitted in higher numbers, and rely heavily on the ambulance service. Health and social care systems and services need to undergo transformations to ensure that all people who access services are treated fairly and effectively.
Bibliographical noteFunding Information:
The authors acknowledge the help and guidance provided by the staff of the Honest Broker Service (HBS) within the Business Services Organisation (BSO), Northern Ireland, particularly, the support of Siobhan Morgan throughout the process and latterly, Gary Ewing and Neil Marsden. The HBS is funded by the BSO and the Department of Health, Social Services and Public Safety for Northern Ireland (DHSSPSNI). The authors are responsible for the interpretation of the data and any views or opinions presented are solely theirs and do not necessarily represent those of the BSO. Disclosure: The authors report no conflicts of interest. Corresponding Author: Deborah Goode, PhD, School of Nursing, Faculty of Life and Health Sciences, Ulster University, Magee Campus, Northland Rd, London-derry BT48 7JL, United Kingdom (D.Goode@ulster. ac.uk).
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- database analysis
- emergency care
- emergency department
- mental health
- older adults