Outcomes Associated With an Age-Friendly Emergency Department Intervention.

Abstract

To assess whether an emergency department (ED) modified comprehensive geriatric assessment (mCGA) designed to address the unique needs of older adults was associated with lower hospital admissions without negative unintended consequences. We conducted a quasi-experimental study of older adults presenting to an academic medical center ED May 1, 2021, to April 30, 2024. Patients were eligible if they were aged 65+ years, had an Emergency Severity Index between 2 and 5, and were present in the ED during mCGA service hours. Our intervention group was eligible patients who received the mCGA and the control group was those who met all inclusion criteria but did not receive the mCGA. We defined 4 outcome variables-hospital admissions, ED length of stay, ED revisits within 72 hours of discharge, and ED revisits within 30 days of discharge-and assessed their relationship to the primary mCGA intervention using propensity-score weighted regression models. A total of 1,119 ED visits received the mCGA and 1,612 served as controls. Those who received the mCGA had an 11.6% (95% confidence interval [CI]: -16.4 to -6.8) lower likelihood of inpatient admission. We did not find a significant association between the mCGA and ED length of stay (-1.5 hours; 95% CI -3.4 to 0.3) or ED revisits within 72 hours (1.7%; 95% CI -1.2 to 4.6) or 30 days of discharge (-1.9%; 95% CI -5.8 to 2.0). The mCGA intervention was associated with significantly lower inpatient admissions from the ED for older adults with no significant negative unintended consequences in the form of longer ED length of stay or ED revisits.