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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
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Outcomes Associated With an Age-Friendly Emergency Department Intervention.

Julia Adler-Milstein1, Sarah W Rosenthal1, Robert Thombley1

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|August 21, 2025
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Summary
This summary is machine-generated.

A modified comprehensive geriatric assessment (mCGA) in the emergency department (ED) significantly reduced hospital admissions for older adults. This intervention did not lead to longer ED stays or increased revisits, demonstrating a safe and effective approach.

Keywords:
Age-friendly health systemGeriatric emergency departmentHospital admissionsInterdisciplinary careOlder adults

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Area of Science:

  • Geriatric Medicine
  • Emergency Medicine
  • Health Services Research

Background:

  • Older adults often present unique challenges in emergency departments (EDs).
  • A modified comprehensive geriatric assessment (mCGA) was developed to address these specific needs.
  • The impact of mCGA on hospital admissions and ED outcomes requires evaluation.

Purpose of the Study:

  • To determine if an ED-based mCGA reduces hospital admissions for older adults.
  • To assess if mCGA is associated with negative unintended consequences, such as increased ED length of stay or revisits.
  • To evaluate the effectiveness of mCGA in managing elderly patients in the ED setting.

Main Methods:

  • A quasi-experimental study design was employed, comparing patients who received mCGA to a control group.
  • The study included older adults (65+ years) presenting to an academic medical center ED.
  • Propensity-score weighted regression models analyzed outcomes including hospital admissions, ED length of stay, and revisits within 72 hours and 30 days.

Main Results:

  • The mCGA group showed an 11.6% lower likelihood of inpatient admission compared to the control group.
  • No significant association was found between mCGA and ED length of stay.
  • The intervention did not significantly increase ED revisits within 72 hours or 30 days of discharge.

Conclusions:

  • The mCGA intervention is associated with a significant reduction in inpatient admissions for older adults presenting to the ED.
  • The mCGA demonstrated no significant negative unintended consequences regarding ED length of stay or patient revisits.
  • Implementing mCGA in the ED is a promising strategy for improving care for the elderly population.