A recent analysis of geriatric patients hospitalized through emergency departments shows that proper geriatric assessments of older patients may reduce admission rates.
A recent article published in Age and Ageing by the Oxford University Press reviewed the evidence behind performing comprehensive geriatric assessments (CGA) for more elderly patients that present at the emergency department. The admission rates for geriatric patients at hospitals have risen since 2006 at a pace that is approximately 6% faster than their population change. As a result, this influx of patients is not met with the appropriate amount of available beds. Additionally, the older population use 41% of the bed space when they represent only 18 % of the population. Although hospitalizations are, of course, necessary to treat some health conditions, there are risks involved as well. There is an increase in loneliness and the worsening of depression-like symptoms far more in older people who become isolated at the hospital. In addition, physical deconditioning, and the risk of contracting a hospital-borne illness is a risk of hospitalization.
Hospital records note that the average stay of the older patient spans two weeks, occupying much bed space and reducing its availability for other new admissions. To address this problem, researchers have found that geriatric assessments differ slightly from regular evaluations done at the emergency departments and this may lead to the right management strategies to determine whether older individuals do need to be admitted at the current rate. The purpose of such initiatives to assess the actual necessity of admission is so that unnecessary bed occupancy is not restricting the bed being available to someone who is in extreme need of hospital admission.
The results of the review show that complete geriatric assessments brought down the admission rates in the emergency setting without compromising the holistic and targeted care to older patients. The patient assessments done using the comprehensive geriatric assessments have shown to help reduce costs required for the geriatric population while increasing their health outcomes. As the government hopes to reduce the 41% administration rates of geriatric patients to provide better overall health to other age groups in the population, the use of the complete geriatric assessments seems to accomplish that goal. These results had limitations, and more work is needed to add to the findings. These results show that comprehensive geriatric assessments may provide better management strategies to manage the influx of patients.
Written by Dr. Apollina Sharma, MBBS, GradDip EXMD
Jay, Samuel, et al. “Can consultant geriatrician led comprehensive geriatric assessment in the emergency department reduce hospital admission rates? A systematic review.” Age and Ageing 46.3 (2017): 366-372.