Development of a Unified Geriatric Emergency Department Database, 2022

Recent initiatives have aimed to improve emergency care for older adults by supporting the recognition of geriatric emergency departments (GEDs). Our objective was to create a unified database of GEDs to understand the distribution and growth of US GEDs.

We identified United States emergency departments (EDs) that were members of the Geriatric ED Collaborative (GEDC) or accredited by the Geriatric ED Accreditation (GEDA) program by December 31, 2022. For completeness, we also identified hospitals recognized by the Age Friendly Health Systems (AFHS), although this recognition is not ED-specific. We collected the year each facility first received recognition and incorporated the combined list into the 2022 National ED Inventory-US database.

We identified 324 GEDs (5.8%) among 5,622 nonfederal EDs in 2022. An additional 202 hospitals were recognized by AFHS, yielding 526 (9.4%) potential GEDs (pGEDs). GEDs (and pGEDs) were disproportionally located in urban areas. From 2017 to 2019, 110 (69%) of 160 pGEDs were in nonteaching hospitals, and from 2020 to 2022, 316 (86%) of 366 were. This rise in nonteaching hospital pGEDs was driven largely by AFHS hospitals, but a similar pattern was observed among GEDs (GEDC and GEDA). Attainment of GEDA was more likely among EDs in GEDC (odds ratio 13.56, 95% confidence interval 6.14 to 29.96) than AFHS-recognized hospitals (odds ratio 3.26, 95% confidence interval 2.15 to 4.95).

The different requirements of GEDC, GEDA, and AFHS-along with current findings-support inclusion of GEDC or GEDA only in the unified national GED database. Furthermore, there was an increase in the number of pGEDs in nonteaching hospitals since 2017. We encourage further efforts to expand these 2 ED-based programs into nonurban, community EDs.