Background
Older Australians account for a substantial proportion of Emergency Department (ED) presentations and hospital admissions. Geriatric Emergency Department Innovation (GEDI) provides early geriatrician assessment in the ED, however evidence regarding downstream inpatient outcomes remains limited.
Aims
To evaluate whether geriatrician assessment in the ED for older adults prior to general medicine admission is associated with improved inpatient discharge-related outcomes.
Methods
This unmatched retrospective cohort study was conducted at a metropolitan tertiary hospital in Melbourne, Australia. Patients aged ≥70 admitted under general medicine receiving in-person geriatrician assessment between 1 January and 31 December 2024 were compared with a randomly sampled, month-distributed general medicine cohort. Exclusions were length of stay (LOS) ≤1 day, inter-unit transfer or palliative care, incomplete data, or non-index admissions. Outcomes included acute LOS, weekday and weekend LOS, 30-day representation, time to geriatrician-led care, and prolonged LOS ≥14 days.
Results
70 GEDI and 307 control patients were analysed. GEDI patients were frailer and had a higher proportion of cognitive impairment. Overall LOS and 30-day representation were similar. Weekday LOS was shorter with GEDI (median 4.9 vs 6.1 days, p=0.048). Time to geriatrician-led care was shorter (7.5 vs 12.8 days, p=0.002). GEDI was associated with lower odds of LOS ≥14 days (OR 0.35, p=0.02).
Conclusion
GEDI was not associated with reduced overall LOS or representation. Exploratory findings suggest potential benefit with earlier geriatrician-led care and shorter weekday LOS. These findings support further prospective, adequately powered studies.