The Impact of the Demographic Aging on the Operation of the Emergency Department (ED)

Introduction: The continuous aging population and declining birth rates bring continuous growth of health needs and health costs. Under these new circumstances, health care systems will have to undergo significant changes both in health care delivery systems, as well as in the funding’s. Aim: This study aimed to investigate the effect of continuing aging of the population in the efficient and effective operation of the ED, and to identify and review relevant research studies related to the topic. Method: This is a systematic review of research articles related to the topic. The search was conducted during March to April 2016, via the electronic data bases PubMed, Cochrane library, Willey online library, Google Scholar, using the keywords "Aging population”, “Emergency department” “elderly patient” , “Older people” and combinations of them. Articles’ inclusion criteria were the publication date (the last 15 years) and the written language, in Greek and English. Results: The search has identified 97 published articles of which nine met the inclusion criteria and were mostly cross-sectional quantitative surveys. Through the analysis of the articles, it was found that the high rates of use of the EDs by the elderly affect the operation of the EDs as well as the hospitals’ bed occupancy and availability. Moreover elderly beyond the frequent use of emergency care and ambulance service, require higher health costs and longer lengths of stay in the ED and in the hospital for the delivery of care. It was also apparent the phenomenon of frequent ED and hospital revisits. Conclusions: There is a need for continuing systematic monitoring of the emergency department from both the scientific community and the political leaders, in order to continually reassess the impact of population aging on both EDs and health care systems, aiming to carry out on time the necessary reformations needed to contain health costs, and to improve the quality of delivered care to the elderly.