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Show 177 THE UNIVERSITY OF UTAH RESEARCH POSTERS ON THE HILL 2012 TREATMENT TRAJEC TORIES FOR INJURED OLDER ADULTS FROM RURAL AREAS Laura Swinyard, (Linda S. Edelman) College of Nursing University of Utah Treatment Trajectories for Injured Older Adults from Rural Areas Laura Swinyard and Linda S. Edelman PhD, RN Laura Swinyard College of Nursing Linda S. Edelman Background • Injuries are a leading cause of injury and death in adults aged 65 years and older. • Rural older adults who are injured may experience different treatment trajectories than their urban counterparts. • There is a lack of research studying rural and urban differences in injuries occurring to older adults. Research questions 1. Do rates of injury differ between rural and urban older adult populations in Utah? 2. Does the level and frequency of health care access differ between rural and urban older adults with injuries? Method • Probabilistic linkage of Utah's Emergency Department (ED), Hospital Discharge and vital records (death) databases identified 32,437 adults 65 years of age and older who were injured during 2007-2008. • Injuries were categorized according to the CDC framework for presenting injury and mortality data. • Injury rates were determined from U.S. Census 2010 data. • Geographic information systems mapping was used to identify counties with highest rates of injuries. • Statistics were performed using SPSS. Significant was set at 0.05. Conclusions 1. The highest rates of injuries for older adults were in rural Utah counties. Falls were the predominant injury; however, they accounted for a smaller percentage of rural injuries. 2. A. Treatment trajectories for rural older adults with injuries are similar to urban older adults with the majority of injuries first treated at an ED. Less than half of the patients were hospitalized during the study period. B. Older rural adults who experienced an injury had significantly more ED and hospital visits during the two year study period compared to urban older adults. However, the number of hospital visits that were injury related was significantly decreased for rural older adults. Implications for rural health Older adults from many rural Utah counties are more likely to experience an injury than older adults living along the Wasatch Front. These injuries are less likely due to falls. Older rural adults who experience an injury are more likely to have ED and hospital visits that are non-injury related, suggesting that they may have more chronic health problems than urban older adults. 1. Injury rates 2. A. Level of treatment for injuries 2. B. Number of ED and hospital visits Total Rural Urban Average number of all ED visits (range) 1.29 (0-49) 1.34* (0-49) 1.27 (0-32) Average number of injury related ED visits (range) 1.01 (0-12) 1.04 (0-12) 1.0 (0-9) Average number of all Hospital visits (range) 0.71 (0-49) 0.71* (0-49) 0.71 (0-21) Average number of injury related Hospital visits (range) 0.39 (0-9) 0.37* (0-5) 0.40 (0-9) *p<0.05 rural versus urban Lawrence T. and Janet T. Dee Foundation Introduction: Falls are the leading cause of injury and death in older adults aged 65 years and older. Rural older adults who are injured may experience different treatment trajectories than their urban counterparts. The purpose of this study is to determine if rural and urban older adults with injuries access health care differently. Introduction: Falls are the leading cause of injury and death in older adults aged 65 years and older. Rural older adults who are injured may experience di erent treatment trajectories than their urban counter-parts. The purpose of this study is to determine if rural and urban older adults with injuries access health care di erently. Results: Most injured older adults (70.6%) lived in the 4 urban counties along the Wasatch Front. Signi - cantly more injuries occurring to rural older adults were rst treated at an ED compared to urban older adults (82.2 and 78.5% respectively; p<0.05). A majority of rural and urban older adults had one or more ED visits (84.5 and 87.5% respectively; range 1-43 visits) during the two-year study period. Fewer rural and urban older adults were hospitalized one or more times (37.6 and 40% respectively; range 1-12 hospital-izations). The overall mortality rate during the study period was 11.7% for rural and 12.5% for urban older adults. Conclusions: The majority of older adults, particularly those living in rural counties, receive initial treatment in an ED and are then discharged or transferred to another hospital. Current data analysis is examining the association of the initial injury with subsequent ED and HOSP visits and deaths as well as whether rural and urban di erences are due to injury severity or access to care. |