Geriatric assessment and intervention in an emergency department observation unit reduced re-attendance and hospitalisation rates

摘要

Aim: To determine the efficacy of geriatric assessment and intervention in an emergency department observation unit (EDOU). Methods: This was a single-centre, before/after prospective study. The control group received the usual EDOU care. Intervention group received geriatric assessment and intervention before discharge. Patients were followed up at 3, 6, 9 and 12 months. End-points included falls and functional scores obtained via telephone, and unscheduled ED re-attendance and hospitalisation obtained through electronic records. Results: The study population included 172 control and 315 intervention group patients. A total of 71.7% of patients in the intervention group had hidden needs that required intervention. The intervention group had significantly less ED re-attendance (adjusted incidence rate ratio (IRR) 0.59, 95% confidence interval (CI) 0.48-0.71) and hospitalisation rates (adjusted IRR 0.64, 95% CI 0.51-0.79) at 12 months. Conclusion: Older patients admitted to an EDOU are an at-risk group and benefit from geriatric assessment before discharge.