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Elderly more likely to wait in French ERs: study

By Andrew M. Seaman

NEW YORK (Reuters Health) - People age 75 and older are more likely than younger patients to wait longer than they should in emergency rooms, according to a new study from France.

The study's lead author cautioned, however, that the finding doesn't mean older patients receive worse care or that they should avoid going to the ER.

Instead, "we want to highlight the fact that physicians may be reluctant to see difficult patients, old patients and sick patients," said Dr. Yonathan Freund, an emergency physician at the Hospital Pitié-Salpetriere in Paris.

"I'm not saying that any patients should be concerned," he told Reuters Health.

Previous research has found that older patients tend to wait longer for care in ERs elsewhere, including in the U.S., the researchers write in the Annals of Emergency Medicine.

That's important, they add, because studies have linked longer waiting times to delayed urgent care, more deaths and a greater risk of being admitted to the hospital.

For the new study, Freund and his colleagues analyzed data on 317,793 adults who came to one of nine ERs in and around Paris during 2011.

Of those, 173,629 waited longer than recommended for someone in their condition before being assessed by a doctor. Those target wait times vary from 0 minutes to 4 hours.

Overall, 53 percent of patients younger than 75 waited longer than recommended, compared to 64 percent of people age 75 and older.

"There are many things that can be responsible for this longer wait in time," Freund said.

"Some of this may just reflect that (doctors) are making a choice to see the simplest patient earlier but then decide to go back and spend more time with the older patient," said Dr. Tim Platts-Mills, an emergency medicine doctor at the University of North Carolina at Chapel Hill School of Medicine.

For example, it would probably be appropriate for a doctor to take one minute to assess a younger patient with a sprained ankle if the doctor can then spend 10 minutes with an older patient, said Platts-Mills, who reviewed the new study for the journal.

"Older adults are - on average - more complicated than younger adults. They take more medication and have more (health problems). And sometimes, it takes more time to assess," he told Reuters Health.

Freund said that more research is needed to tease out the reasons behind the longer waits.

Also, he cautioned that the results may not apply to every country or every ER.

SOURCE: http://bit.ly/13lfr7p Annals of Emergency Medicine, online May 28, 2013.