Diagnosis of Elder Abuse in U.S. Emergency Departments

Christopher S. Evans, Katherine M. Hunold, Tony Rosen, Timothy F. Platts-Mills

Research output: Research - peer-reviewArticle

  • 2 Citations

Abstract

Objectives: To estimate the proportion of visits to U.S. emergency departments (EDs) in which a diagnosis of elder abuse is reached using two nationally representative datasets. Design: Retrospective cross-sectional analysis. Setting: U.S. ED visits recorded in the 2012 Nationwide Emergency Department Sample (NEDS) or the 2011 National Hospital Ambulatory Medical Care Survey (NHAMCS). Participants: All ED visits of individuals aged 60 and older. Measurements: The primary outcome was elder abuse defined according to International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes. The proportion of visits with elder abuse was estimated using survey weights. Odds ratios (ORs) were calculated to identify demographic characteristics and common ED diagnoses associated with elder abuse. Results: In 2012, NEDS contained information on 6,723,667 ED visits of older adults, representing an estimated 29,056,673 ED visits. Elder abuse was diagnosed in an estimated 3,846 visits, corresponding to a weighted diagnosis period prevalence of elder abuse in U.S. EDs of 0.013% (95% confidence interval (CI) = 0.012–0.015%). Neglect and physical abuse were the most common types diagnosed, accounting for 32.9% and 32.2% of cases, respectively. Multivariable analysis showed greater weighted odds of elder abuse diagnosis in women (odds ratio (OR) = 1.95, 95% CI = 1.68–2.26) and individuals with contusions (OR = 2.91, 95% CI = 2.36–3.57), urinary tract infection (OR = 2.21, 95% CI = 1.84–2.65), and septicemia (OR = 1.92, 95% CI = 1.44–2.55). In the 2011 NHAMCS dataset, no cases of elder abuse were recorded for the 5,965 older adult ED visits. Conclusion: The proportion of U.S. ED visits by older adults receiving a diagnosis of elder abuse is at least two orders of magnitude lower than the estimated prevalence in the population. Efforts to improve the identification of elder abuse in EDs may be warranted.

LanguageEnglish (US)
Pages91-97
Number of pages7
JournalJournal of the American Geriatrics Society
Volume65
Issue number1
DOIs
StatePublished - Jan 1 2017

Fingerprint

Elder Abuse
Hospital Emergency Service
Odds Ratio
Confidence Intervals
Health Care Surveys
Datasets
Contusions
International Classification of Diseases
Urinary Tract Infections
Sepsis
Cross-Sectional Studies
Demography
Weights and Measures
Population
Physical Abuse
Surveys and Questionnaires

Keywords

  • elder abuse
  • emergency department
  • prevalence

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Diagnosis of Elder Abuse in U.S. Emergency Departments. / Evans, Christopher S.; Hunold, Katherine M.; Rosen, Tony; Platts-Mills, Timothy F.

In: Journal of the American Geriatrics Society, Vol. 65, No. 1, 01.01.2017, p. 91-97.

Research output: Research - peer-reviewArticle

Evans, Christopher S. ; Hunold, Katherine M. ; Rosen, Tony ; Platts-Mills, Timothy F./ Diagnosis of Elder Abuse in U.S. Emergency Departments. In: Journal of the American Geriatrics Society. 2017 ; Vol. 65, No. 1. pp. 91-97
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