VA Maryland Health Care System

Seniors Put Off ER Visits at Start of Month, New VA Study Shows

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April 25, 2008

(Baltimore) According to a new study by researchers at the Veterans Affairs (VA) Maryland Health Care System, Baltimore area seniors are avoiding visits to the emergency room at the beginning of every month.  An apparent cause is a shared fear that their mailed Social Security checks might be stolen in their absence.  

The two-year study was conducted at the Baltimore VA Medical Center, a division of VA Maryland Health Care System.  Dr. David A. Jerrard, the Chief of Emergency Care Services at the Baltimore VA Medical Center, led the study. 

On 96 dates between December 2003 and November 2005, Dr. Jerrard and his team tracked patient flow through the Baltimore VA Medical Center’s emergency department’s sign-in registration logs, assessing the frequency of visits by patients both above and below 62 years of age.  In addition, researchers examined the volume of visits at the start of the month as compared to mid-month.

The study’s findings were conclusive: with patients over 62, there was a 25-30% drop-off in emergency department visits at the beginning of the month as compared to the middle of the month.  An average of 23 older patients registered for each of the two days at the beginning of the month, when Social Security checks usually arrive, as opposed to 30 patients registering during the middle of the month.  The study also showed that patients under the age of 62 did not fluctuate significantly in the number of their ER visits throughout the month.

This trend had been observed informally by emergency personnel for years, but not clearly documented until the current study.  “We had been noting a drop-off in senior patient visits at the first of the month for some time,” says Dr. Jerrard.  “We decided to conduct a formal study to determine if what we thought was the case anecdotally was true.”

Jerrard’s team intends to explore this issue further by examining the incidence of complaints in the emergency room by this age group following the start of the month.  “In other words, we want to see whether patients who delayed their care actually were suffering from a greater degree of illness when they did come in,” says Jerrard.
Dr. Jerrard, who is also a an Associate Professor of Emergency Medicine at the University of Maryland Medical Center, believes that the study’s findings can help emergency department physicians to be more prepared in managing the care needs of this patient age group.  He also thinks the study can be used to educate patients themselves not to postpone their care needs.  “The message is that if you’re suffering from chest or abdominal pains, even though your intentions are good, there is a potential for your illness to become more serious if you delay your care,” he says.

Dr. Jerrard’s study was presented at the International Conference on Emergency Medicine in San Francisco on Friday, April 4, 2008.