TY  - JOUR
PY  - 2023//
TI  - Dealing with the elder abuse epidemic: disparities in interventions against elder abuse in trauma centers
JO  - Journal of the American Geriatrics Society
A1  - El-Qawaqzeh, Khaled
A1  - Hosseinpour, Hamidreza
A1  - Gries, Lynn
A1  - Magnotti, Louis J.
A1  - Bhogadi, Sai Krishna
A1  - Anand, Tanya
A1  - Ditillo, Michael
A1  - Stewart, Collin
A1  - Cooper, Zara
A1  - Joseph, Bellal
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: Elder abuse is a major cause of injury, morbidity, and death. We aimed to identify the factors associated with interventions against suspected physical abuse in older adults. <br><br>METHODS: Analysis of the 2017-2018 ACS TQIP. All trauma patients ≥60 years with an abuse report for suspected physical abuse were included. Patients with missing information on abuse interventions were excluded. Outcomes were rates of abuse investigation initiation following an abuse report and change of caregiver at discharge among survivors with an abuse investigation initiated. Multivariable regression analyses were performed. <br><br>RESULTS: Of 727,975 patients, 1405 (0.2%) had an abuse report. Patients with an abuse report were younger (mean, 72 vs 75, p < 0.001), and more likely to be females (57% vs 53%, p = 0.007), Hispanic (11% vs 6%, p < 0.001), Black (15% vs 7%, p < 0.001), suffer from dementia (18% vs 11%, p < 0.001), functional disability (19% vs 15%, p < 0.001), have a positive admission drug screen (9% vs 5%, p < 0.001) and had a higher ISS (median [IQR], 9 [4-16] vs 6 [3-10], p < 0.001). Perpetrators were members of the immediate/step/extended family in 91% of cases. Among patients with an abuse report, 1060 (75%) had abuse investigations initiated. Of these, 227 (23%) resulted in a change of caregiver at discharge. On multivariate analysis for abuse investigation initiation, male gender, private insurance, and management at non-level I trauma centers were associated with lower adjusted odds (p < 0.05), while Hispanic ethnicity, positive admission drug screen, and penetrating injury were associated with higher adjusted odds (p < 0.05). On multivariate analysis for change of caregiver, male gender, and private insurance were associated with lower adjusted odds (p < 0.05), while functional disability and dementia were associated with higher adjusted odds (p < 0.05). <br><br>CONCLUSIONS: Significant gender, ethnic, and socioeconomic disparities exist in the management of physical abuse of older adults. Further studies are warranted to expand on and address the contributing factors underlying these disparities. LEVEL OF EVIDENCE: III. STUDY TYPE: Therapeutic/Care Management.<p />  <p>Language: en</p>
LA  - en
SN  - 0002-8614
UR  - http://dx.doi.org/10.1111/jgs.18286
ID  - ref1
ER  -