Factors influencing frequency and appropriateness of utilization of the emergency room by the elderly.

The authors analyzed predictors of the frequency and appropriateness of utilization of an emergency room by a random sample of 75 noninstitutionalized persons aged 65 years and older in a large city in Canada, using the Andersen and Newman model of medical care utilization as a framework. The total amount of variance explained in the frequency of utilization (47%) exceeded that explained by other studies of utilization of various health services by the elderly. Attitude toward health care, prior experience with the hospital system, and number of sources of health care were important predictors of the frequency of presentation to the emergency room. Almost one half (46.7%) were appropriate users; younger age and prior experience were important predictors of appropriateness of use. The results suggest that the elderly are more appropriate users of the emergency room than younger persons; educational interventions by family physicians could contribute to further improvement.