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Do geriatric interventions reduce emergency department visits? A systematic review
1Department of Clinical Epidemiology and Community Studies, St. Mary's Hospital Center, 3830 Lacombe Ave., Room 2508, Montreal, QC H3T 1M5. jane.mccusker@mcgill.ca
Summary
Comprehensive geriatric assessment interventions can reduce emergency department (ED) visits for older adults when implemented in outpatient or home care settings. Hospital-based interventions showed minimal impact on ED utilization.
Area of Science:
- Gerontology
- Health Services Research
- Public Health
Background:
- Emergency departments (EDs) face increasing demand from an aging population.
- Limited research exists on the impact of geriatric assessment interventions on ED use.
- This study systematically reviews interventions targeting ED visits in older adults.
Purpose of the Study:
- To systematically review and compare the effects of comprehensive geriatric assessment interventions on emergency department visits.
- To identify which types of geriatric interventions are most effective in reducing ED utilization.
Main Methods:
- Systematic literature review of original research (English/French) on noninstitutionalized individuals aged 60+.
- Inclusion criteria focused on interventions with ED visits as an outcome.
- Data abstraction and verification using a standardized protocol.
Main Results:
- Twenty-six studies were identified, employing various designs including randomized controlled trials.
- Hospital-based interventions had minimal effect on ED utilization.
- Outpatient, primary care, or home care interventions, including geriatric assessment and case management, effectively reduced ED visits.
Conclusions:
- Geriatric interventions in outpatient or home care settings show promise for reducing ED visits.
- Further research with improved methodologies and standardized measures is necessary.
- Innovative geriatric interventions require rigorous evaluation for their impact on ED utilization.