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Acute Care of the Elderlyor. Learning to love frailty Suzanne MasonProfessor of Emergency MedicineUniversity of Sheffield, UK

Not sexyNo gizmos / gadgetsNo targetsWhere is Scott Weingart when we need him???Toenails, tottering and toileting

How manyWhenDo they need to comeHowAdmissionsExperiencesMaking it better

ED attendances by age

Av. 25.9%Based on analysis of 16 EDs and 1.03 million patient visits (HSCIC data 2011-2014)

seasonal variation slight increase in winter monthsIncrease over 3 years

4

Arriving by ambulance

Av. 64.2%

Unnecessary AttendanceUnnecessary, N (%)Necessary, N (%)Total, N (%)16 24145,413 (21.0)529,738 (76.4)693,747 (100.0)25 34124,876 (19.9)483,426 (77.2)626,587 (100.0)35 4497,032 (18.5)414,753(79.0)525,192 (100.0)45 5481,471 (16.5)401,104 (81.4)492,837 (100.0)55 6448,207 (13.0)316,317 (85.3)370,626 (100.0)65 7430,034 (8.8)306,718 (90.1)340,457 (100.0)75 8420,543 (5.6)341,306 (93.6)364,453 (100.0)85+9,715 (3.8)242,666 (95.7)253,702 (100.0)Total557,291 (15.2)3,036,028 (82.8)3,667,601 (100.0)

Missing data excluded for this presentation

Admitted patients by age

Av. 52.3%

Older peoples experience of ED

Spike accounted for 6.3% 65 yrsTotal time in ED for older people 47 minsOlder people likely to stay >1hr longer than younger patients14/06/2016 The University of Sheffield8

Patient level data for 15 EDs

Is it changing?Attendances 65+ by 234/ year (95% CI: 148 to 320, P