Understanding Local Consultation Patterns of Inpatient Geriatric Medicine Teams: a Cross-Sectional Study

Geriatric consultation for Comprehensive Geriatric Assessment (CGA) improves outcomes of older adults living with frailty who are hospitalized, but consultation patterns and utilization of inpatient geriatric consultation teams by other hospital-based services are poorly understood.

We conducted a cross-sectional study using linked health administrative data to describe characteristics of older adults (≥ 65 years) who received a CGA while hospitalized between January 1, and December 31, 2019. We identified hospital-based services requesting CGA and the frequency and reasons for referral. We used multivariable logistic regression to estimate the association between patient-level characteristics and receiving a CGA.

A total of 29,090 older adults were admitted to hospital; 38.7% were classified as frail and 5.4% (1,563 patients) received at least one CGA. The top three reasons for requesting a CGA were to assess the need for care on an inpatient geriatric rehabilitation unit (43%), and for assessment and management of delirium (27%) and dementia (24%). Referrals were most frequently received from Hospitalists (48%). Frailty was associated with increased odds of receiving a CGA (adjusted odds ratio [aOR] 12.02; 95% confidence interval [CI] 9.67-14.82). A diagnosis of cancer was associated with lower odds of receiving a CGA (aOR 0.75; 95% CI 0.60-0.93).

Inpatient geriatric consultation teams support 5.4% of hospitalized older adults. With the rapidly growing aging population, future efforts are needed to explore the optimal delivery of inpatient geriatric services to support its sustainable provision.