Unmet need and psychological distress predict emergency department visits in community-dwelling elderly women: a prospective cohort study

BMC Geriatrics

Research Article

Abby Lippman¹  Christina Wolfson²  Jacqueline M Quail³ 

[1] Department of Epidemiology and Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada;Department of Epidemiology and Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada;Research Institute, McGill University Health Centre, Montreal, Quebec, Canada;Department of Epidemiology and Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada;Saskatchewan Health Quality Council, Saskatoon, Saskatchewan, Canada;

关键词: Emergency Department;    Psychological Distress;    Emergency Department Visit;    Baseline Interview;    Mini Mental State Exam;   

DOI  :  10.1186/1471-2318-11-86

 received in 2010-11-08, accepted in 2011-12-19,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundUnmet need to perform activities of daily living (ADL) is associated with increased use of urgent health services by the elderly. However, the reported associations may be confounded by psychological distress. We examine the independent effects of unmet need and psychological distress upon emergency department (ED) visits.MethodsWe conducted a prospective study of randomly selected community-dwelling adults aged ≥ 75. We report here the results for women only (n = 530). In-person interviews collected data on self-reported unmet need and the 14-item l'Indice de détresse psychologique de Santé Québec psychological distress scale. ED visits were identified from an administrative database. Multivariable logistic regression was used to identify predictors of any ED visit in the 6 months following the baseline interview.ResultsIn multivariable analysis, unmet need in instrumental ADL was associated with subsequent ED visits (odds ratio = 1.57, 95% confidence interval = 1.02-2.41), as was psychological distress (odds rate = 1.30, 95% confidence interval = 1.02-1.67). The magnitude of the association between unmet need and ED visits was overestimated in statistical models that did not adjust for psychological distress.ConclusionsBoth unmet need and psychological distress were independent predictors of ED visits. Future investigations of unmet need and health services utilization should include psychological distress to control for confounding and improve the internal validity of statistical models.

【 授权许可】

CC BY   
© Quail et al; licensee BioMed Central Ltd. 2011