ABSTRACT

The number of elderly patients has been increasing rapidly since the era of population aging. A majority of the patients need emergency medical services (EMS), and demographic and clinical characteristics of them are much different from those of the younger patients. Multiple comorbidities are common in this population, and diagnosis is difficult because of communication problems caused by various factors. In addition, both atypical presentations of illness and nonspecific complaints complicate their evaluation and diagnosis at the emergency department. Therefore, the current EMS system should be changed according to the needs and characteristics of the elderly patients. Specifically, there should be a section in the emergency room (i.e., geriatric emergency rooms) that specializes in dealing with the elderly patients or a geriatric hospital ward with emergency room functions. The system, in which paramedics dispatched to provide EMS transport the patients, should also be changed. Appropriately trained and qualifies paramedics should be able to transfer the patients to primary health clinics or provide primary care based on patient evaluation, and transfer to a specialized treatment (e.g., stroke center) center rather than an emergency room according to the patient’s illness condition. Such system changes can eventually improve the quality of life of the elderly patients and reduce excessive use of emergency rooms.