This study estimated the proportion of visits to U.S. emergency departments (EDs) in which a diagnosis of elder abuse was reached, using two nationally representative datasets.
The study design was a retrospective cross-sectional analysis. It encompassed U.S. ED visits recorded in the 2012 Nationwide Emergency Department Sample (NEDS) or the 2011 National Hospital Ambulatory Medical Care Survey (NHAMCS). The focus was on all ED visits of individuals aged 60 and older. 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. The study concludes that 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. 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 percent (95-percent confidence interval (CI) = 0.012-0.015 percent). Neglect and physical abuse were the most common types diagnosed, accounting for 32.9 percent and 32.2 percent of cases, respectively. Multivariable analysis showed greater weighted odds of elder abuse diagnosis in women (odds ratio (OR) = 1.95, 95 percent CI = 1.68-2.26) and individuals with contusions (OR = 2.91, 95 percent CI = 2.36-3.57), urinary tract infection (OR = 2.21, 95 percent CI = 1.84-2.65), and septicemia (OR = 1.92, 95 percent 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. (Publisher abstract modified)